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Individual

SEAN PAUL WALDRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
1070 HILINE RD STE 210, POCATELLO, ID 83201-2947
(208) 478-9081
(208) 478-4999
Mailing address
1597 SUMMER WAY, IDAHO FALLS, ID 83404-8258
(208) 522-0175

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
31792
ID

Other

Enumeration date
03/07/2012
Last updated
03/07/2012
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