Individual
SALLIE SUBLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 E CENTER ST, POCATELLO, ID 83201-5737
(208) 233-9204
Mailing address
5675 HILO DR, POCATELLO, ID 83204-4625
(208) 232-8838
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-339
ID
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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