Individual
NELIDA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1075 E PARK BLVD, BOISE, ID 83712-7722
(208) 381-5970
Mailing address
1075 E PARK BLVD, BOISE, ID 83712-7722
(208) 381-5970
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-8861150
ID
Other
Enumeration date
08/12/2019
Last updated
10/10/2025
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