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Individual

MS. KODI CATANIA HIRST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

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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