Individual
DANIEL JEROME HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
717 MISSION ROAD, FORT HALL, ID 83203
(208) 237-5631
(208) 237-5796
Mailing address
PO BOX 306, FORT HALL, ID 83203-0306
(208) 237-5631
(208) 237-5796
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW30964
ID
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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