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Individual

MS. KRISTA MARIE GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
150 SHOUP AVE, IDAHO FALLS, ID 83402-3657
(208) 716-4372
Mailing address
725 E 600 N, FIRTH, ID 83236-1205
(208) 716-4372

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW 33036
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-35402
ID

Other

Enumeration date
07/15/2013
Last updated
03/25/2016
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