Individual
MR. TERRY ALAN TIPPERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2424 BANK DR, BOISE, ID 83705-2565
(208) 342-3612
(208) 342-0327
Mailing address
2424 BANK DR, BOISE, ID 83705-2565
(208) 342-3612
(208) 342-0327
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-850
ID
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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