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Organization

BAY ROOTS COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MADELINE B PAUL LCSW (SELF)
(251) 725-3907
Entity
Organization

Contact information

Practice address
6168 ARAPAHOE ST, POCATELLO, ID 83204-5078
(251) 725-3907
Mailing address
6168 ARAPAHOE ST, POCATELLO, ID 83204-5078
(251) 725-3907

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
07/11/2025
Last updated
07/11/2025
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