| Roger C Ehlert, Phd Pa | |
|
424 E Sherman Ave Suite 107 Coeur D Alene ID 83814-1701 | |
| (208) 667-0544 | |
| (208) 667-0544 |
| Full Name | Roger C Ehlert, Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 424 E Sherman Ave, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Roger Claus Ehlert (OWNER) |
| Authorized Official Contact | 2086670544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roger C Ehlert, Phd Pa 424 E Sherman Ave Suite 107 Coeur D Alene ID 83814-1701 Ph: (208) 667-0544 | Roger C Ehlert, Phd Pa 424 E Sherman Ave Suite 107 Coeur D Alene ID 83814-1701 Ph: (208) 667-0544 |
| NPI Number | 1326162835 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 07/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326162835 | NPI | - | NPPES |
| N0567 | Other | BLUE CROSS OF IDAHO | |
| 000010015973 | Other | REGENCE BLUE SHIELD OF ID | |
| N4700 | Other | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY56 (Idaho) | Primary |
| 103T00000X | Psychologist | PY00000622 (Washington) | Secondary |
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