Individual
REBECCA NELSON MUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
343 E 4TH N STE 128, REXBURG, ID 83440-6004
(208) 351-3086
Mailing address
665 W MAIN ST, REXBURG, ID 83440-1889
(208) 351-3086
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40249
ID
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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