Individual
TIARA LITTLEDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
815 N COLLEGE RD, TWIN FALLS, ID 83301-3484
(208) 814-9100
(208) 814-9903
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9569161-3502
UT
1041C0700X
Clinical Social Worker
9569161-3501
UT
1041C0700X
Clinical Social Worker
Primary
LCSW-45118
ID
Other
Enumeration date
02/20/2013
Last updated
10/16/2024
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