Individual
MS. KAREN LARISSA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
Mailing address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36855
ID
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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