Individual
CORY BLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2235 E 25TH ST, SUITE 190, IDAHO FALLS, ID 83404-7519
(208) 991-4296
(208) 261-1922
Mailing address
2235 E 25TH ST, SUITE 190, IDAHO FALLS, ID 83404-7519
(208) 991-4296
(208) 261-1922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW 35281
ID
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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