Individual
JUANITA M BAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5001 CHERRY GULCH LN, EMMETT, ID 83617-5123
(208) 365-3437
Mailing address
PO BOX 678, EMMETT, ID 83617-0678
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34721
ID
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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