Individual
MR. NATHAN WILLIAM BLUMENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
420 W 4TH S, REXBURG, ID 83440-2319
(208) 656-4017
(208) 656-4018
Mailing address
420 W 4TH S, REXBURG, ID 83440-2319
(907) 854-1972
(208) 656-4018
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
43020
ID
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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