Individual
YEZENIA LORA-SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 3 BOX 288, BLACKFOOT, ID 83221-9792
(208) 339-5686
Mailing address
RR 3 BOX 288, BLACKFOOT, ID 83221-9792
(208) 339-5686
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW35292
ID
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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