Individual
MS. KODI CATANIA HIRST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5999 W STATE ST STE B, BOISE, ID 83703-5059
(208) 853-5095
(208) 853-5125
Mailing address
5999 W STATE ST STE B, BOISE, ID 83703-5059
(208) 853-5095
(208) 853-5125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-30196
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-30196
IDAHO BUREAU OF OCCUPATIONAL LICENSE
ID
Enumeration date
08/24/2010
Last updated
08/24/2010
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