Individual
KATEY LYNN GOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW27130
Contact information
Practice address
140 N CORNER ST, IDAHO FALLS, ID 83402-4032
(208) 523-0785
(208) 523-0785
Mailing address
1740 E 17TH ST STE B, IDAHO FALLS, ID 83404-6375
(208) 529-8832
(208) 522-8725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW27130
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002648300
—
ID
05
—
807375600
—
ID
Enumeration date
05/15/2008
Last updated
05/15/2008
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