Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 11540040 | ID |
NPI | 1003102500 |
---|---|
Provider Name | Dr. Nancy J Schmidt |
First Address | Sandpoint, ID 83864-2116 |
Second Address | Ponderay, ID 83852-9601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 23/03/2016 |