Individual
DARCI REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
321 17TH ST, LEWISTON, ID 83501-2523
(208) 746-3398
Mailing address
321 17TH ST, LEWISTON, ID 83501-2523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-40947
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-40947
IDAHO BOARD OF OCCUPATIONAL LICENSES
ID
Enumeration date
06/22/2021
Last updated
06/22/2021
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