Individual
MRS. CORRINE TAFOYA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW LCSW
Contact information
Practice address
16 12TH AVE SO, SUITE 103, NAMPA, ID 83651
(208) 461-3720
(208) 461-1787
Mailing address
16 12TH AVE SO, SUITE 103, NAMPA, ID 83651
(208) 461-3720
(208) 461-1787
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW562
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807292400
—
ID
01
—
8M061
BLUE SHIELD
—
01
—
E5428
BLUE CROSS
ID
Enumeration date
03/20/2007
Last updated
07/08/2007
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