Individual
MRS. TARA V DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3402 FRANKLIN RD, CALDWELL, ID 83605-6932
(208) 459-0092
Mailing address
3402 FRANKLIN RD, CALDWELL, ID 83605-6932
(208) 459-0092
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36484
ID
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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