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General NPI Number Information
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NPI Number | 1972274868
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Entity Type | Organization
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Legal Business Name | INFLOW THERAPY LLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 4222 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83706-2037
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Country | US
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Telephone | 208-901-8556
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 E RED TAIL CT
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City | EAGLE
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State | ID
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Zip | 83616-4082
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Country | US
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Telephone | 208-901-8556
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | EMILY A YUEN
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Credential | LMSW
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Telephone | 208-901-8556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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