Individual
MALISA WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1281 E IRON EAGLE DR, EAGLE, ID 83616-6599
(208) 912-4011
Mailing address
5650 N DALSPRING AVE, BOISE, ID 83713-1315
(208) 912-4011
(208) 939-5535
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-38838
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184011124
—
ID
Enumeration date
04/16/2015
Last updated
01/29/2021
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