Individual
MRS. OLISA BOMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 746-5700
(208) 799-6504
Mailing address
428 6TH AVE, LEWISTON, ID 83501-2355
(208) 746-5700
(208) 799-6504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW 29090
ID
Other
Enumeration date
07/16/2013
Last updated
09/17/2025
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