Individual
DR. CLEO PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCSW, LICSW
Contact information
Practice address
366 GUNFIGHTER AVE # 366MDG, MOUNTAIN HOME AFB, ID 83648-5258
(208) 828-7655
Mailing address
5955 ZEAMER AVE # 673MDG, JBER, AK 99506-3702
(907) 580-3205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
61261680
WA
1041C0700X
Clinical Social Worker
Primary
LCSW-34797
ID
Other
Enumeration date
07/19/2012
Last updated
07/10/2023
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