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General NPI Number Information
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NPI Number | 1790081032
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Entity Type | Organization
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Legal Business Name | SENSITIVE MENTAL HEALTHCARE PLLC
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Dates
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Enumeration Date | 02/03/2011
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 7905 N MEADOWLARK WAY SUITE B
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City | COEUR D ALENE
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State | ID
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Zip | 83815-5041
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Country | US
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Telephone | 208-818-1411
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Fax | 208-772-7677
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Provider Business Mailing Address
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Address Line | 419 N BRUSHWOOD CT
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City | POST FALLS
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State | ID
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Zip | 83854-6764
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Country | US
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Telephone | 208-818-1411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BONNIE S WILSON
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Credential | NP
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Telephone | 208-818-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP-999A
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License Number State | ID
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