Individual
ADRIENNE BOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
496 A ST, IDAHO FALLS, ID 83402-3617
(208) 552-7100
(208) 552-7101
Mailing address
496 A ST, IDAHO FALLS, ID 83402-3617
(208) 552-7100
(208) 552-7101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-27497
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010158241
REGENCE BLUESHIELD NUMBER
ID
Enumeration date
11/24/2006
Last updated
07/09/2007
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