NPI age
19 years
Enumerated 2007-03-20
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 807292400 | |
| 01 | 8M061 | BLUE SHIELD |
| 01 (ID) | E5428 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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