Individual
MARY LU OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1605 S KIMBALL AVE, CALDWELL, ID 83605-4548
(208) 454-2766
(208) 454-2771
Mailing address
PO BOX 4824, BOISE, ID 83711-4824
(208) 697-6922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-24912
ID
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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