Individual
AVERY THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1021 W HEMINGWAY BLVD, NAMPA, ID 83651-1763
(208) 505-9990
Mailing address
307 HILDAGO WAY, CALDWELL, ID 83605-1161
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9271160
ID
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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