Individual
THOMAS MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7520
Mailing address
6175 S INTERCON WAY, BOISE, ID 83716-7018
(208) 424-6686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17249
MN
Other
Enumeration date
02/07/2006
Last updated
07/08/2007
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