NPI Code Details Logo

NPI 1366950933

NPI 1366950933 : COURTNEY EDMONSON PSYD : POST FALLS, ID

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366950933
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    COURTNEY EDMONSON PSYD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/17/2018
-----------------------------------------------------
    Last Update Date     |    09/25/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    761 N THORNTON ST STE E 
-----------------------------------------------------
    City                 |    POST FALLS
-----------------------------------------------------
    State                |    ID
-----------------------------------------------------
    Zip                  |    83854-6105
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-289-2642
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    761 N THORNTON ST STE E 
-----------------------------------------------------
    City                 |    POST FALLS
-----------------------------------------------------
    State                |    ID
-----------------------------------------------------
    Zip                  |    83854-6105
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-289-2642
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    13409800-2501
-----------------------------------------------------
    License Number State |    UT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    103TC0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Psychologist
-----------------------------------------------------
    License Number       |    PSY-203726
-----------------------------------------------------
    License Number State |    ID
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.