Provider Demographics
NPI:1144771338
Name:HOYT, HEATHER E (PHD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:E
Last Name:HOYT
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 1:671 E RIVERPARK LN
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4066
Mailing Address - Country:US
Mailing Address - Phone:208-344-2071
Mailing Address - Fax:208-344-2075
Practice Address - Street 1:671 E RIVERPARK LN
Practice Address - Street 2:SUITE 220
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-6559
Practice Address - Country:US
Practice Address - Phone:208-344-2071
Practice Address - Fax:208-344-2075
Is Sole Proprietor?:No
Enumeration Date:2016-10-22
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202988103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID81-4210118OtherTAX ID