Individual
DEANNA M THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60123318
WA
1041C0700X
Clinical Social Worker
Primary
LCSW-41432
ID
1041C0700X
Clinical Social Worker
LW60746127
WA
Other
Enumeration date
07/25/2006
Last updated
07/20/2023
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