Organization
RIVER WELLNESS CENTER PLLC
Active
Organization
RIVER WELLNESS CENTER PLLC
Active
Other names
Amber Graham
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMBER GRAHAM LCSW (OWNER)
(208) 731-2896
Entity
Organization
Contact information
Practice address
139 RIVER VISTA PL STE 106C, TWIN FALLS, ID 83301-3060
(208) 731-0664
Mailing address
2216 SETTLERS LN, TWIN FALLS, ID 83301-7889
(208) 731-2896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-39383
STATE LICENSE NUMBER
ID
Enumeration date
07/03/2020
Last updated
07/03/2020
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