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Individual

SUSAN HELEN HENNIGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2005 N IRONWOOD PKWY STE 113, COEUR D ALENE, ID 83814-2614
(208) 758-8302
(208) 758-0850
Mailing address
2005 N IRONWOOD PKWY STE 113, COEUR D ALENE, ID 83814-2614
(208) 758-8302
(208) 758-0850

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW - 1136
ID
1041C0700X
Clinical Social Worker
LW 00008547
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8940571
L&I CRIME VICTIMS
WA
Enumeration date
09/30/2005
Last updated
05/24/2024
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