Stanton, Gary Louis

Stanton, Gary Louis is an individual health care provider with primary practice located at 1115 Ironwood Drive , Coeur D Alene ID 83814-4936. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Stanton, Gary Louis can be contacted via phone (208) 765-0955.

Contact Information

Primary practice address
1115 Ironwood Drive Coeur D Alene ID 83814-4936
Phone: (208) 765-0955
Fax: (208) 765-6972
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY376 Idaho

Profile Details

NPI number 1952495228
LBN Legal business name Stanton, Gary Louis
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 19 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 1952495228 NPPES
Idaho Other X3924 BLUE CROSS
Idaho Other 000010016544 BLUE CROSS

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