Individual
CEDRIC JOESPH DECORY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2273 S VISTA AVE STE 190, BOISE, ID 83705-7341
(208) 343-2737
Mailing address
4724 W FRANKLIN RD, BOISE, ID 83705-1217
(208) 412-0230
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-39243
ID
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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