NPI age
19 years
Enumerated 2006-10-18
Across 2000 active social worker providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | L5931 | IDAHO BLUE CROSS PIN |
| 01 (ID) | 82052319683404B005 | TRICARE BILLING NUMBER |
| 05 (ID) | 805384500 |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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