Individual
IVY TRUC NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
5999 W STATE ST, BOISE, ID 83703-5059
(208) 853-5095
Mailing address
2092 N DEVLIN AVE, MERIDIAN, ID 83646-7327
(208) 230-3185
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-35671
ID
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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