Individual
ANNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
(208) 236-6328
Mailing address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
(208) 236-6328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-31943
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-31943
BUREAU OF OCCUPATIONAL LICENSES FOR STATE OF IDAHO
ID
Enumeration date
03/22/2016
Last updated
03/22/2016
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