Individual
WILLIAM BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1032 S BRIDGE WAY PL, SUITE 100, EAGLE, ID 83616-6099
(208) 246-0123
(208) 246-0125
Mailing address
1032 S BRIDGE WAY PL, SUITE 100, EAGLE, ID 83616-6099
(208) 246-0123
(208) 246-0125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW10
ID
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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