Individual
SUSIE KEETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1720 N WESTGATE DR STE A, BOISE, ID 83704-7164
(208) 334-0979
Mailing address
1720 N WESTGATE DR STE A, BOISE, ID 83704-7164
(208) 334-0979
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW1411
ID
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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