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Individual

BENJAMIN DAVID GERTHUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
531 BRYDEN AVE, LEWISTON, ID 83501-4438
(208) 798-1646
Mailing address
531 BRYDEN AVE, LEWISTON, ID 83501-4438
(208) 717-1376

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44093
ID

Other

Enumeration date
09/06/2023
Last updated
09/06/2023
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