Individual
ASHLYN ALEXIS WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 GARRETT WAY STE 47, POCATELLO, ID 83201-5132
(208) 595-6732
(208) 904-0792
Mailing address
3970 STOCKMAN RD, POCATELLO, ID 83204-2004
(208) 220-9517
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-45409
ID
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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