Provider Demographics
NPI:1477917722
Name:DIANE BARNHILL SUNTIGER ENTERPRISES
Entity Type:Organization
Organization Name:DIANE BARNHILL SUNTIGER ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:OF
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LCPC
Authorized Official - Phone:208-602-8867
Mailing Address - Street 1:2010 N FRY ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7619
Mailing Address - Country:US
Mailing Address - Phone:208-602-8867
Mailing Address - Fax:208-378-7686
Practice Address - Street 1:1001 N 27TH ST
Practice Address - Street 2:INFINITY AND WELLNESS CENTER
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-2202
Practice Address - Country:US
Practice Address - Phone:208-602-8867
Practice Address - Fax:208-378-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-11101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty