NPI age
17 years
Enumerated 2009-01-21
Across 2138 active clinical (social worker) providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 1041C0700X | TAXONOMY |
| 05 (ID) | 806968300 | |
| 01 (ID) | 20001460 | PTAN |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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