Individual
MS. SAMANTHIA LOU WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
(208) 736-2177
(208) 736-2113
Mailing address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
(208) 736-2177
(208) 736-2113
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
N24948
ID
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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