Individual
ITZEL LABRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1970 E 17TH ST STE 208, IDAHO FALLS, ID 83404-8048
(208) 932-0668
(208) 932-0809
Mailing address
1970 E 17TH ST STE 208, IDAHO FALLS, ID 83404-8048
(208) 932-0668
(208) 932-0809
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW38542
ID
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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