Individual
KAMILLE ELDENE ARIEL MANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
1619 S EUCLID AVE, BOISE, ID 83706-3519
(986) 999-2103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-42673
ID
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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