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CRAIG W. BEAVER PH.D.

Clinical Neuropsychologist

Boise, Idaho

Provider NPI: 1225176498

Provider Information:
 CRAIG W. BEAVER PH.D.
Gender: M
Sole Proprietor


Practice Location:
250 BOBWHITE CT STE 220  BOISE, ID 83706 US
Tel: 208-336-2972  Fax: 208-336-4408

Business Mailing Address:
250 BOBWHITE CT STE 220  BOISE, ID 83706 US
Tel: 208-336-2972  Fax: 208-336-4408

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
IDPSY-173

Other Provider Identifiers:

IssuerNumberStateType
BLUE SHIELD000010016209ID01
BLUE CROSSN1730ID01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS ID - Page 1



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