NPI age
19 years
Enumerated 2006-06-15
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 063892602 | |
| 05 (ID) | 1831133461 |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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