Individual
KATRINA M DASENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1254 BANNOCK AVE, IDAHO FALLS, ID 83402-2055
(513) 815-1548
Mailing address
1254 BANNOCK AVE, IDAHO FALLS, ID 83402-2055
(513) 815-1548
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-40451
ID
Other
Enumeration date
03/11/2016
Last updated
03/31/2025
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