Individual
MISS JOANNA LAREE TRUSSEL BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2539 CHANNING WAY STE 100, IDAHO FALLS, ID 83404-7558
(208) 521-9946
Mailing address
PO BOX 372, RIGBY, ID 83442-0372
(208) 521-9946
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-33843
ID
Other
Enumeration date
04/17/2007
Last updated
07/23/2024
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