Individual
RANDAL HALLENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1276 W RIVER ST STE 100, BOISE, ID 83702-7083
(208) 608-9058
(208) 344-0127
Mailing address
1276 W RIVER ST STE 100, BOISE, ID 83702-7083
(208) 608-9058
(208) 344-0127
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-25776
ID
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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