Individual
MRS. THEOTOSCA PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
890 N COLE RD, BOISE, ID 83704-8638
(208) 287-2564
(208) 287-2570
Mailing address
890 N COLE RD, BOISE, ID 83704-8638
(208) 287-2564
(208) 287-2570
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
30631
ID
Other
Enumeration date
11/18/2010
Last updated
02/11/2014
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