Individual
MISS EMILY RICKS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-34678
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 529-1660
(208) 524-7335
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW34678
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056-0197374
—
ID
Enumeration date
01/25/2012
Last updated
01/15/2019
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