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Individual

MR. GABELIO CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 205-1000
Mailing address
720 N GEORGIA AVE, CALDWELL, ID 83605-2507
(208) 891-8451

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-38728
ID
1041C0700X
Clinical Social Worker
Primary
8861139
ID

Other

Enumeration date
09/08/2022
Last updated
03/04/2025
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