Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | AA-283 | AK |
N | 103T00000X | Psychologist | AA-283 | AK |
Y | 102L00000X | Psychologist | PSY-202403 | ID |
Y | 103T00000X | Psychologist | PSY-202403 | ID |
NPI | 1003086513 |
---|---|
Provider Name | Dr. Barbara Alison Minton |
First Address | Boise, ID 83712-6689 |
Second Address | Boise, ID 83702-5024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 24/11/2017 |