Boise Brain Health

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

BOISE BRAIN HEALTH

Practice address

4696 W Overland Rd Ste 228
Boise, ID 83705-2864

Phone

(208) 917-1692

Fax

(208) 914-7643

NPI assigned

Feb 18, 2019

Last updated

Feb 18, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sarah D Marion, PH.D.

Title

Managing Member

Phone

(208) 917-1692

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1790241404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 228",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052864",
            "telephone_number": "208-917-1692",
            "fax_number": "208-914-7643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 228",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052864",
            "telephone_number": "208-917-1692",
            "fax_number": "208-914-7643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE BRAIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "MARION",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "208-917-1692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Neuropsychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.