Individual
LAURA M BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2235 E 25TH ST, SUITE 220, IDAHO FALLS, ID 83404-7519
(208) 522-9812
(208) 522-9859
Mailing address
2235 E 25TH ST, SUITE 220, IDAHO FALLS, ID 83404-7519
(208) 522-9812
(208) 522-9859
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-33021
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881708832
—
ID
Enumeration date
06/05/2013
Last updated
06/17/2013
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