Individual
VANESSA DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 782-1322
(208) 782-1322
Mailing address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 782-1322
(208) 782-1322
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1761669
ID
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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