Individual
PAGE LYN ERNTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-6556
Mailing address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-6556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-8911438
ID
Other
Enumeration date
09/05/2023
Last updated
10/01/2025
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