Individual
NICOLE L THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
725 POLE LINE RD W, TWIN FALLS, ID 83301-5800
(208) 814-1699
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW30170
ID
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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