Individual
ELIZABETH ANN IDROGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
(541) 884-2338
Mailing address
507 INDIO ST, TULELAKE, CA 96134-9278
(530) 640-0925
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223354
—
OR
Enumeration date
11/16/2012
Last updated
11/16/2012
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