Individual
CAMILLE R SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
921 S ORCHARD ST, BOISE, ID 83705-1992
(208) 803-7963
Mailing address
921 S ORCHARD ST, BOISE, ID 83705-1992
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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