Individual
MRS. LINDSEY NICHOLE PETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
13403 N GOVERNMENT WAY STE 319, HAYDEN, ID 83835-8905
(208) 755-1641
Mailing address
4926 N ORCHID LN, COEUR D ALENE, ID 83815-8748
(208) 755-1641
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
37776
ID
1041C0700X
Clinical Social Worker
Primary
41681
ID
Other
Enumeration date
02/03/2021
Last updated
12/20/2022
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