person
Dr. Edward John Northam, PHD
Professional Counselor in Nampa, Idaho
NPI 1326059072

Edward John Northam is a Professional Counselor based in Nampa, ID and is specialized in Professional. Edward John Northam practices in Nampa, ID and has the professional credentials of PHD. The NPI Number for Edward John Northam is 1326059072 and holds a License No. 406 (Idaho).

The current practice location address for Edward John Northam is 923 16Th Ave S, Nampa, ID and can be reached out via phone at 208-965-8788 and via fax at 208-965-2789.

Location: 923 16Th Ave S, Nampa, ID, 83651-4731
person
Provider Profile Details
NPI Number
1326059072
Provider Name
Edward John Northam
Credential
PHD
Provider Entity Type
Individual
Gender
Male
Address
923 16Th Ave S, Nampa, ID, 83651-4731
Phone Number
208-965-8788
Fax Number
208-965-2789
Provider Enumeration Date
08/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
91185390827 05 NE
345988000 01 NE MAGELLAN
114961 01 NE VALUE OPTIONS
84913 01 NE BLUE CROSS BLUE SHIELD
91185390826 05 NE
institution
Provider Business Practice Location Address Details
Address
923 16Th Ave S
City
State
Zip
83651-4731
Phone Number
208-965-8788
Fax Number
208-965-2789
person
Provider Business Mailing Address Details
Address
923 16Th Ave S
City
State
Zip
83651-4731
Phone Number
208-965-8788
Fax Number
208-965-2789
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
5698 (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
406 (Nebraska)
Definition
Definition to come...
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