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General NPI Number Information
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NPI Number | 1982418257
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Entity Type | Organization
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Legal Business Name | FULL SPECTRUM PSYCHOLOGY LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 675 E ANDERSON ST
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City | IDAHO FALLS
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State | ID
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Zip | 83401-2020
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Country | US
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Telephone | 208-419-9238
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Fax | 208-598-7998
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Provider Business Mailing Address
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Address Line | 675 E ANDERSON ST
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City | IDAHO FALLS
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State | ID
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Zip | 83401-2020
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Country | US
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Telephone | 208-432-1976
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Fax | 208-278-7956
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Authorized Official
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Title or Position | OWNER-PSYCHOLOGIST
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Name | DR. AARON A HARRIS
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Credential | PHD
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Telephone | 208-419-9238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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