Individual
LETA A. STOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
422 17TH ST, LEWISTON, ID 83501-2526
(208) 743-4680
(208) 743-1756
Mailing address
422 17TH STREET, PO BOX 2145, LEWISTON, ID 83501
(208) 743-4680
(208) 743-1756
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW30956
ID
Other
Enumeration date
02/27/2013
Last updated
06/12/2013
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