Individual
MIRANDA ARISBET HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 S MAIN ST, PAYETTE, ID 83661-2853
(208) 406-4245
Mailing address
250 S MAIN ST, PAYETTE, ID 83661-2853
(208) 406-4245
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40800
ID
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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