Individual
MS. SUSAN DORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
720 E. ALICE, BLACKFOOT, ID 83221
(208) 785-5898
(208) 785-5877
Mailing address
P. O. BOX 129, BLACKFOOT, ID 83221
(208) 785-5898
(208) 785-5877
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-518
ID
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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