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Individual

TIFFANY RAE SNODGRASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 505-2000
Mailing address
8456 W LIMELIGHT ST APT 106, BOISE, ID 83714-6191
(562) 619-3882

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
37473
ID

Other

Enumeration date
01/29/2019
Last updated
01/29/2019
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