NPI age
18 years
Enumerated 2007-10-02
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | LCSW-34346 | STATE LICENSURE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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