Individual
BRADEN CLARK MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
361 2ND AVE WEST, TWIN FALLS, ID 83301
(208) 308-7533
Mailing address
361 2ND AVE W, 361 2ND AVE WEST, TWIN FALLS, ID 83301-5804
(208) 308-7533
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8729371-3502
ID
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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