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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