Individual
KENNETH DALE WIDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
305 E 37TH ST, GARDEN CITY, ID 83714-6419
(208) 331-0900
(208) 331-0904
Mailing address
PO BOX 8803, BOISE, ID 83707-2803
(208) 412-8338
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-31550
ID
Other
Enumeration date
07/14/2026
Last updated
07/14/2026
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