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General NPI Number Information
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NPI Number | 1487310702
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Entity Type | Organization
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Legal Business Name | NORTH IDAHO NEUROTHERAPY LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 102 S EUCLID AVE STE 312
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City | SANDPOINT
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State | ID
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Zip | 83864-4938
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Country | US
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Telephone | 208-255-6057
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Fax |
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Provider Business Mailing Address
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Address Line | 217 CEDAR ST # 177
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City | SANDPOINT
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State | ID
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Zip | 83864-1410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINDA LARSON
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Credential | PH D, LMFT
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Telephone | 208-255-6057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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