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Individual

TATEN LEE ALBRIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
Mailing address
967 HOOPES AVE APT 201, IDAHO FALLS, ID 83404-4705
(208) 313-1842

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-39331
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518097690
ID
Enumeration date
03/23/2020
Last updated
03/23/2020
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