Individual
KA-SIA MICHELLE BAUMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
630 S WOODRUFF AVE STE B, IDAHO FALLS, ID 83401-6472
(360) 688-0564
(208) 529-2148
Mailing address
1459 MOUNTAIN VIEW LN, IDAHO FALLS, ID 83402-1813
(606) 880-5643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-29998
ID
Other
Enumeration date
01/03/2008
Last updated
05/07/2024
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