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Michael Theodore Richardson
Peer Specialist in Nampa, Idaho
NPI 1477336923

Michael Theodore Richardson is a Peer Specialist based in Nampa, ID. Michael Theodore Richardson practices in Nampa, ID. The NPI Number for Michael Theodore Richardson is 1477336923 and holds a License No. (Idaho).

The current practice location address for Michael Theodore Richardson is 824 17Th Ave S Ste 5, Nampa, ID and can be reached out via phone at 208-901-9274.

Location: 824 17Th Ave S Ste 5, Nampa, ID, 83651-4781
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477336923
Provider Name
Michael Theodore Richardson
Credential
Provider Entity Type
Individual
Gender
Male
Address
824 17Th Ave S Ste 5, Nampa, ID, 83651-4781
Phone Number
208-901-9274
Fax Number
Provider Enumeration Date
08/17/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
824 17Th Ave S Ste 5
City
Nampa
State
Idaho
Zip
83651-4781
Phone Number
208-901-9274
Fax Number
person
Provider Business Mailing Address Details
Address
824 17Th Ave S Ste 5
City
Nampa
State
Idaho
Zip
83651-4781
Phone Number
208-901-9274
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Idaho)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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