| Wise Mind Online Therapy | |
| 16252 E 3rd St Bayview ID 83803-8002 | |
| (208) 243-3332 | |
| Not Available | 
| Full Name | Wise Mind Online Therapy | 
|---|---|
| Speciality | Clinic/center - Adult Mental Health | 
| Location | 16252 E 3rd St, Bayview, Idaho | 
| Authorized Official Name and Position | Travis Reed Stephens (OWNER) | 
| Authorized Official Contact | 2082433332 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Wise Mind Online Therapy 16252 E 3rd St Bayview ID 83803-8002 Ph: () - | Wise Mind Online Therapy 16252 E 3rd St Bayview ID 83803-8002 Ph: (208) 243-3332 | 
| NPI Number | 1831802446 | 
|---|---|
| Provider Enumeration Date | 12/28/2022 | 
| Last Update Date | 12/28/2022 | 
| Certification Date | 12/28/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1831802446 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |