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Individual

ALEC MICHAEL GEDWILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
524 S 9TH AVE STE 103, CALDWELL, ID 83605-5072
(208) 454-8555
Mailing address
1511 W LOWRY ST, MERIDIAN, ID 83646-3128
(925) 858-8423

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
9271575
ID

Other

Enumeration date
10/07/2024
Last updated
03/04/2026
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