Individual
ROSHAHARRA DANIEL FELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1125 E HAWAII AVE, NAMPA, ID 83686-6210
(208) 475-3858
Mailing address
4427 W ALPINE ST, BOISE, ID 83705-1330
(208) 283-6817
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-30854
ID
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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