Doctor Name: | MARK ALBRECHT |
NPI Number: | 1508267469 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LCSW-996 |
Business Practice Address: | 100 Golden Eagle Dr S Hailey, ID - 833335129 |
Business Phone Number: | 2083092717 |
Business Fax Number: | |
Mailing Address: | Po Box 2171, HAILEY |
State: | ID |
Postal Code: | 833332171 |
Phone Number: | 2083092717 |
Fax Number: | |
NPI Enumeration Date: | 09/10/2014 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LCSW-996 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |