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Individual

TRACY MARIE GROVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1909 S 10TH AVE, CALDWELL, ID 83605-4842
(208) 863-3450
Mailing address
1909 S 10TH AVE, CALDWELL, ID 83605-4842
(208) 863-3450

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-32904
ID

Other

Enumeration date
05/13/2013
Last updated
05/13/2013
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