Individual
CARLA LILIAN VELEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 576-0964
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
42197
ID
Other
Enumeration date
07/22/2022
Last updated
07/22/2022
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