Individual
MR. DOUGLAS ROY WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
307 19TH ST STE A3, LEWISTON, ID 83501-2086
(208) 746-2948
Mailing address
730 WARNER AVE # B, LEWISTON, ID 83501-4916
(208) 746-2948
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CSW511
ID
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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