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Individual

MRS. SIERRA JANE DE MELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
2550 ADDISON AVE E STE G, TWIN FALLS, ID 83301-6748
(208) 814-7750
Mailing address
701 21ST AVE E, JEROME, ID 83338-4937
(208) 358-3107

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
442460
ID

Other

Enumeration date
09/19/2023
Last updated
09/19/2023
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