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Individual

KAPKA ZLATKOVA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
7711 W RIVERSIDE DR, BOISE, ID 83714-6182
(208) 853-8536
Mailing address
7711 W RIVERSIDE DR, BOISE, ID 83714-6182
(208) 853-8536

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-37069
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LMSW-37069
BUREAU OF OCCUPATIONAL LICENSES
ID
Enumeration date
01/30/2018
Last updated
06/16/2018
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