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Individual

ROBERT NEIL TANGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1276 W RIVER ST, SUITE 100, BOISE, ID 83702-7066
(208) 338-4699
(208) 322-4711
Mailing address
1276 W RIVER ST, SUITE 100, BOISE, ID 83702-7066
(208) 338-4699
(208) 322-4711

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-27787
ID

Other

Enumeration date
08/08/2013
Last updated
08/08/2013
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