Individual
GAY M MIREMONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
611 CLINIC RD, CHALLIS, ID 83226-4824
(208) 879-4351
Mailing address
PO BOX 980, CHALLIS, ID 83226-0980
(208) 879-4351
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW1397
ID
Other
Enumeration date
09/26/2013
Last updated
06/21/2023
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