Individual
LILIA CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(801) 850-3019
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-38811
ID
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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