Individual
MRS. PENNY L DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
515 N 16TH ST, PAYETTE, ID 83661-2774
(208) 642-6416
(208) 642-2829
Mailing address
515 N 16TH ST, PAYETTE, ID 83661
(208) 642-6416
(208) 642-2829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28740
ID
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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