Individual
TIMOTHY J COLLIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1471 SHORELINE DR, SUITE 119, BOISE, ID 83702-6879
(208) 345-2630
(208) 345-6504
Mailing address
1471 SHORELINE DR, SUITE 119, BOISE, ID 83702-6879
(208) 345-2630
(208) 345-6504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW-200
ID
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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