Individual
MICHALA IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8100 W EMERALD ST STE 150, BOISE, ID 83704-9057
(208) 375-0752
Mailing address
8100 W EMERALD ST STE 150, BOISE, ID 83704-9057
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-31432
ID
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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