Individual
MR. GARY MCKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1477 RIVIERA DR, IDAHO FALLS, ID 83404-5618
(208) 522-5032
Mailing address
1477 RIVIERA DR, IDAHO FALLS, ID 83404-5618
(208) 522-5032
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-82
ID
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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