Provider Demographics
NPI:1003086513
Name:MINTON, BARBARA ALISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ALISON
Last Name:MINTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6689
Mailing Address - Country:US
Mailing Address - Phone:208-344-0916
Mailing Address - Fax:
Practice Address - Street 1:1403 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5024
Practice Address - Country:US
Practice Address - Phone:208-867-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202403103T00000X
AKAA-283103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist