Individual
MS. MICHAELLA A. HAMMERSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30410 HIGHWAY 200 STE 200R-3, PONDERAY, ID 83852-9601
(208) 620-4861
Mailing address
30410 HIGHWAY 200 STE 200R-3, PONDERAY, ID 83852-9601
(208) 620-4861
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-8911188
ID
Other
Enumeration date
01/10/2023
Last updated
12/17/2025
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