Individual
DALANA JUSTESEN-BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, CADC
Contact information
Practice address
762 FALLS AVE, TWIN FALLS, ID 83301-3316
(208) 734-4200
(208) 734-1404
Mailing address
605 11TH AVE E, GOODING, ID 83330-5368
(208) 934-8461
(208) 934-5437
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11540036
ID
104100000X
Social Worker
Primary
LSW-30781
ID
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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