NPI age
15 years
Enumerated 2010-08-03
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 83-4294531 | IRS |
| 01 (ID) | LCSW-33391 | CLINICAL LICENSURE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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