Individual
KAREN O ILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
631 N 200 E, REXBURG, ID 83440-3599
(208) 356-6975
Mailing address
245 E 1ST S, SAINT ANTHONY, ID 83445-2120
(208) 351-4869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-25913
ID
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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