Individual
BEN LAZARUS FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1309 CAMAS ST, BLACKFOOT, ID 83221-3060
(208) 782-0675
Mailing address
1309 CAMAS ST, BLACKFOOT, ID 83221-3060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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