Beaver, Craig W.

Beaver, Craig W. is an sole proprietor health care provider with primary practice located at 250 Bobwhite Ct Ste 220 , Boise ID 83706-3983. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Beaver, Craig W. can be contacted via phone (208) 336-2972.

Contact Information

Primary practice address
250 Bobwhite Ct Ste 220 Boise ID 83706-3983
Phone: (208) 336-2972
Fax: (208) 336-4408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY-173 Idaho

Profile Details

NPI number 1225176498
LBN Legal business name Beaver, Craig W.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225176498 NPPES
Idaho Other 000010016209 BLUE SHIELD
Idaho Other N1730 BLUE SHIELD

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