Individual
NICHOLAS MILLIREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
4672 S WHITMORE WAY, BOISE, ID 83709-3471
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
37268
ID
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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