Individual
RICARDO FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 559-6421
Mailing address
1273 E FORT ERIE ST, KUNA, ID 83634-5593
(208) 559-6421
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40073
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZF355800F
DRIVER'S LICENSE
ID
Enumeration date
02/14/2023
Last updated
02/14/2023
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