Organization
MILLIE GAITAN COUNSELING PLLC
Active
Other names
MILLIE GAITAN COUNSELING
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MILDRED A GAITAN GONZALEZ LCSW (OWNER/PROVIDER)
(208) 421-1024
Entity
Organization
Contact information
Practice address
160 MAIN AVE N, TWIN FALLS, ID 83301-6101
(208) 733-3024
(208) 733-0929
Mailing address
160 MAIN AVE N, TWIN FALLS, ID 83301-6101
(208) 733-3024
(208) 733-0929
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056-0347063
—
ID
Enumeration date
11/29/2021
Last updated
11/29/2021
Update your record
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