Individual
MRS. DEBRA STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
333 SYRINGA CT, LEWISTON, ID 83501-9609
(208) 791-8287
(208) 798-8685
Mailing address
333 SYRINGA CT, LEWISTON, ID 83501-9609
(298) 791-8287
(208) 798-8685
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-520
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015964
BLUESHIELD OF IDAHO
ID
01
—
X0367
BLUE CROSS OF IDAHO
ID
Enumeration date
08/29/2005
Last updated
03/30/2026
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