Individual
MR. LUTHER RYAN HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2640 W SOUTHSLOPE RD, EMMETT, ID 83617-8800
(208) 407-8916
Mailing address
2640 W SOUTHSLOPE RD, EMMETT, ID 83617-8800
(208) 407-8916
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW -30112
ID
1041C0700X
Clinical Social Worker
LCSW30122
ID
Other
Enumeration date
12/22/2009
Last updated
03/03/2020
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