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Individual

MR. JAMES BOUTWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
833 SHOSHONE ST N APT 107, TWIN FALLS, ID 83301-6359
(208) 308-3278
Mailing address
833 SHOSHONE ST N APT 107, TWIN FALLS, ID 83301-6359
(208) 308-3278

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33130
ID

Other

Enumeration date
03/24/2016
Last updated
03/24/2016
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