Individual
MARYLIN EACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
801 N LINCOLN AVE, JEROME, ID 83338-1853
(208) 731-5750
Mailing address
728 EASTLAND DR N, TWIN FALLS, ID 83301-4310
(208) 731-5750
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW 1427
ID
Other
Enumeration date
11/28/2008
Last updated
11/28/2008
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