Individual
TINA MICHELE MARTINDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11407 W REUTZEL DR, BOISE, ID 83709-4404
(208) 866-7059
(208) 375-9232
Mailing address
11407 W REUTZEL DR, BOISE, ID 83709-4404
(208) 866-7059
(208) 375-9232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-35315
ID
Other
Enumeration date
12/14/2015
Last updated
12/05/2023
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