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Individual

MRS. SANDRA LYN VOLLMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
732 WASHINGTON AVE, POCATELLO, ID 83201-3748
(208) 478-9822
Mailing address
3106 CENTER PLEASANT VALLEY RD, AMERICAN FALLS, ID 83211-5365
(208) 406-6011

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-29910
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101Y0800X
ID
Enumeration date
10/28/2010
Last updated
10/28/2010
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