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General NPI Number Information
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NPI Number | 1346684271
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Entity Type | Organization
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Legal Business Name | MAC WEBB PSYCHOLOGY CLINIC PLLC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 408 22ND AVE S
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City | NAMPA
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State | ID
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Zip | 83651-5424
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Country | US
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Telephone | 208-466-8267
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Fax | 208-466-5226
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Provider Business Mailing Address
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Address Line | 408 22ND AVE S
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City | NAMPA
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State | ID
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Zip | 83651-5424
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Country | US
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Telephone | 208-466-8267
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Fax | 208-466-5226
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. MAC C. WEBB
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Credential | ED.D.
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Telephone | 208-284-6746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PSY-42
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License Number State | ID
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