Individual
NAVARA REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6795 N MINERAL DR, COEUR D ALENE, ID 83815-8700
(208) 769-4222
(844) 803-7399
Mailing address
109 E HARRISON AVE, COEUR D ALENE, ID 83814-3238
(208) 660-4675
(208) 666-4122
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36784
ID
1041C0700X
Clinical Social Worker
39279
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2082112
—
WA
Enumeration date
06/07/2017
Last updated
02/26/2020
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