Individual
MR. SCOTT BROBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
265 E CHUBBUCK ROAD, CHUBBUCK, ID 83202
(208) 237-1711
(208) 237-9806
Mailing address
265 E CHUBBUCK ROAD, CHUBBUCK, ID 83202
(208) 237-1711
(208) 237-9806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-40120
ID
1041C0700X
Clinical Social Worker
LMSW-32675
ID
Other
Enumeration date
04/02/2013
Last updated
11/03/2020
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