Provider Demographics
NPI:1720396252
Name:HU, CHIA-CHI (PHD)
Entity Type:Individual
Prefix:
First Name:CHIA-CHI
Middle Name:
Last Name:HU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:HU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:814 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-3049
Mailing Address - Country:US
Mailing Address - Phone:208-883-0619
Mailing Address - Fax:
Practice Address - Street 1:814 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3049
Practice Address - Country:US
Practice Address - Phone:208-310-9032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-202713103TC1900X
WAPY 60176963103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling