Individual
KIRSTEN A BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2273 S VISTA AVE, #190, BOISE, ID 83705-7341
(208) 343-2737
(208) 342-3238
Mailing address
1349 N WILDWOOD ST APT 101, BOISE, ID 83713-5455
(208) 329-0972
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-34554
ID
Other
Enumeration date
10/12/2011
Last updated
08/24/2015
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