Individual
MS. CHERYL GAUDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
(208) 542-0359
Mailing address
615 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 542-0352
(208) 542-0359
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
35379
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518097690
—
ID
Enumeration date
11/15/2017
Last updated
11/15/2017
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