| Cameron Staley Phd Llc | |
|
5026 Cassie Dr Chubbuck ID 83202-5252 | |
| (801) 644-2006 | |
| Not Available |
| Full Name | Cameron Staley Phd Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5026 Cassie Dr, Chubbuck, Idaho |
| Authorized Official Name and Position | Cameron Staley (MANAGER) |
| Authorized Official Contact | 2082695475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cameron Staley Phd Llc 5026 Cassie Dr Chubbuck ID 83202-5252 Ph: (801) 644-2006 | Cameron Staley Phd Llc 5026 Cassie Dr Chubbuck ID 83202-5252 Ph: (801) 644-2006 |
| NPI Number | 1295589935 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295589935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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