Individual
AMANDA NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 S KIMBALL AVE, CALDWELL, ID 83605-4542
(208) 459-1039
Mailing address
16297 MANATEE AVE, CALDWELL, ID 83607-5403
(208) 244-1938
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-30021
ID
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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