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PSYCHOLOGY SERVICES OF IDAHO PLLC

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Company Details

Name: PSYCHOLOGY SERVICES OF IDAHO PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 02 Nov 2000 (25 years ago)
Financial Date End: 30 Nov 2015
Date dissolved: 23 Feb 2016
Entity Number: 54267
Place of Formation: IDAHO
File Number: 0000054267
ZIP code: 83706
County: Ada County
Principal Address: 3123 S TEMPERANCE WAY BOISE, ID 83706

National Provider Identifier

NPI Number:
1437219227

Authorized Person:

Name:
DR. JAMIE CHAMPION
Role:
PSYCHOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
Yes

Contacts:

Fax:
2082882844

Filing

Filing Name Filing Number Filing date
Annual Report 0001129318 2014-09-18
Annual Report 0001129317 2013-09-20
Annual Report 0001129316 2012-09-12
Annual Report 0001129312 2011-09-14
Annual Report 0001129311 2010-09-09

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State