Individual
MR. CARY SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4750 N FIVE MILE RD, BOISE, ID 83713-2715
(208) 996-0931
Mailing address
4430 N HERITAGE WOODS WAY, MERIDIAN, ID 83646-3667
(208) 895-9722
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
574
MT
1041C0700X
Clinical Social Worker
Primary
LCSW-28951
ID
Other
Enumeration date
12/18/2006
Last updated
04/05/2022
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