Individual
ESCA KOEGELENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 S MAIN ST, PAYETTE, ID 83661-2853
(208) 405-0020
Mailing address
2805 ALLEN ST, DALLAS, TX 75204-4018
(903) 918-5008
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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