Individual
LYSANDRA C SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3023 E COPPER POINT DR STE 108, MERIDIAN, ID 83642-9290
(208) 914-8924
Mailing address
3004 W KOOTENAI ST, BOISE, ID 83705-2327
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
38659
ID
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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