Individual
DAKOTAH ANTONY COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2121 N GARNET CREEK AVE, STAR, ID 83669-8001
(208) 740-0544
Mailing address
2121 N GARNET CREEK AVE, STAR, ID 83669-8001
(208) 740-0544
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW45341
ID
Other
Enumeration date
10/26/2018
Last updated
06/12/2024
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