Individual
MR. DANIEL GRAHAM RASMUSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
335 N. MAIN, POCATELLO, ID 83204
(208) 478-8340
(208) 478-8341
Mailing address
335 N MAIN ST, POCATELLO, ID 83204-3108
(208) 478-8340
(208) 478-8341
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-36436
ID
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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