Individual
DANIEL JOSEPH MAC DONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
500 WEST FORT ST, BOISE VAMC, BOISE, ID 83702
(208) 422-1145
Mailing address
5571 S ULEX PL, BOISE, ID 83716-6926
(208) 385-7352
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW #505
ID
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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