Individual
AMANDA GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1005 E PARK BLVD, BOISE, ID 83712-7722
(208) 358-9020
Mailing address
1005 E PARK BLVD, BOISE, ID 83712-7722
(208) 358-9020
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
31356
ID
104100000X
Social Worker
Primary
42528
ID
Other
Enumeration date
01/15/2014
Last updated
02/07/2023
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