| Kathleen Michaud Phd Llc | |
|
2498 N Stokesberry Pl Suite 140 Meridian ID 83646-5150 | |
| (208) 971-5806 | |
| (208) 629-1358 |
| Full Name | Kathleen Michaud Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2498 N Stokesberry Pl, Meridian, Idaho |
| Authorized Official Name and Position | Kathleen M Michaud (CLINCIAL PSYCOLOGIIST, SOLE MBR) |
| Authorized Official Contact | 2089715806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Michaud Phd Llc 2498 N Stokesberry Pl Suite 140 Meridian ID 83646-5150 Ph: (208) 971-5806 | Kathleen Michaud Phd Llc 2498 N Stokesberry Pl Suite 140 Meridian ID 83646-5150 Ph: (208) 971-5806 |
| NPI Number | 1427599885 |
|---|---|
| Provider Enumeration Date | 03/17/2017 |
| Last Update Date | 03/24/2017 |
| Medicare PECOS PAC ID | 8325324890 |
|---|---|
| Medicare Enrollment ID | O20170418000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427599885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY202738 (Idaho) | Primary |
| Provider Name | Kathleen M Michaud |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992997837 PECOS PAC ID: 6204096175 Enrollment ID: I20140919002332 |
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