Individual
MS. PATRECE ELISABETH MOODY MEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
190 W. MAIN STREET, KUNA, ID 83634-0959
(208) 733-1996
Mailing address
PO BOX 959, 190 W. MAIN STREET KUNA COUNSELING CENTER, KUNA, ID 83634-0959
(208) 922-9001
(208) 922-3778
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
457
ID
1041C0700X
Clinical Social Worker
Primary
LCSW 457
ID
Other
Enumeration date
01/18/2006
Last updated
10/31/2013
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