Individual
TAMBRA EVE FOX STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1111 S ORCHARD ST, SUITE 172, BOISE, ID 83705-1966
(208) 336-9591
Mailing address
1465 N TRAIL CREEK WAY, EAGLE, ID 83616-4090
(208) 938-5364
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW - 29319
ID
1041C0700X
Clinical Social Worker
Primary
LCSW - 29319
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LCSW - 29319
—
ID
Enumeration date
02/14/2007
Last updated
07/09/2009
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