NPI age
12 years
Enumerated 2013-07-10
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1417398140 | |
| 05 (ID) | 126556547 | |
| 01 | 1710427513 | TYPE II NPI |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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