Individual
TAYLOR MOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
493 EASTLAND DR, TWIN FALLS, ID 83301-7441
(208) 410-4866
Mailing address
364 S 500 W, JEROME, ID 83338-6025
(208) 420-9708
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-40228
LMSW LICENSE NUMBER
ID
Enumeration date
04/27/2021
Last updated
04/27/2021
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