Organization Name: | PSYCHOLOGICAL ASSESSMENT SPECIALISTS |
NPI Number: | 1023497013 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN L CHRISTENSEN (OWNER/PSYCHOLOGIST) |
Mailing Address: | 1246 Yellowstone Ave Ste C5 Pocatello |
State: | ID US |
Postal Code: | 832014373 |
Phone Number: | 2082330150 |
Fax Number: | 2082330159 |
NPI Enumeration Date: | 05/22/2015 |
NPI Last Update Date: | 05/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SERVICE EXTENDER |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |