NPI age
17 years
Enumerated 2008-09-04
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 12403159 | CAQH |
| 05 (ID) | 002920900 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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