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Individual

MS. MARY THERESA PIERCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6126 W STATE ST, BOISE, ID 83703-2741
(208) 919-5067
Mailing address
2425 HAGUE RD, MIDVALE, ID 83645-5111
(208) 919-5067

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-24710
ID
1041C0700X
Clinical Social Worker
LCSW24710
ID

Other

Enumeration date
08/18/2006
Last updated
07/04/2023
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