Organization
MIDLIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE KAY BOOTHE (BILLER)
(208) 765-5656
Entity
Organization
Contact information
Practice address
1423 N GOVERNMENT WAY, COEUR D ALENE, ID 83814-3335
(208) 691-2515
(208) 665-2398
Mailing address
912 N BALCONY DR, COEUR D ALENE, ID 83814-6899
(208) 691-2515
(208) 665-2398
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW29348
ID
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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