Individual
MRS. CARRIE ALICIA CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802
Mailing address
64 W INDIAN ROCKS ST, MERIDIAN, ID 83646-4980
(407) 267-3789
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
43622
ID
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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