Individual
MR. JUSTIN FORD SMILEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1115 B STREET, PLUMMER, ID 83851
(208) 686-1449
(208) 686-5813
Mailing address
PO BOX 388, PLUMMER, ID 83851-0388
(208) 686-1449
(208) 686-5813
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SOCIAL WORK 24211
ID
Other
Enumeration date
11/08/2005
Last updated
07/08/2007
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