Individual
BRITTANY M OGATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 761-2055
Mailing address
1901 W BELLA ST, BOISE, ID 83702-0722
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
32320
ID
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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