Individual
MAESER GLEYRE FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
Mailing address
196 N 1900 E, REXBURG, ID 83440-2903
(208) 569-6620
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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