Healthcare Provider Details

I. General information

NPI: 1467994616
Provider Name (Legal Business Name): HEATHER ESKRIDGE HOYT PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 E RIVERPARK LANE STE 220
BOISE ID
83706-6559
US

IV. Provider business mailing address

671 E RIVERPARK LANE STE 220
BOISE ID
83706-6559
US

V. Phone/Fax

Practice location:
  • Phone: 208-344-2071
  • Fax: 208-344-2075
Mailing address:
  • Phone: 208-344-2071
  • Fax: 208-344-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-202988
License Number StateID

VIII. Authorized Official

Name: HEATHER E HOYT
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 208-344-2071