NPI age
19 years
Enumerated 2006-08-30
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | L5808 | BLUE CROSS |
| 01 (ID) | 000010144733 | REGENCE BS |
| 05 (ID) | 0028657 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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