Individual
KENNETH CRAIG MINNIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1600 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4300
(208) 529-5276
(208) 529-6506
Mailing address
1600 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4300
(208) 529-5276
(208) 529-6506
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-434
ID
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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