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Individual

MRS. CHIVONNE MARIE MRAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
428 6TH AVE, LEWISTON, ID 83501-2355
(208) 799-6500
(208) 799-6504
Mailing address
428 6TH AVE, LEWISTON, ID 83501-2355
(208) 799-6500
(208) 799-6504

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
RC60019333
WA
1041C0700X
Clinical Social Worker
Primary
LCSW-34755
ID

Other

Enumeration date
06/05/2008
Last updated
11/04/2015
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