Individual
JULIANA LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1806 W EMERALD ST. SUITE 130, BOISE, ID 83704
(208) 600-2184
Mailing address
1806 W EMERALD ST. SUITE 130, BOISE, ID 83704
(208) 600-2184
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40520
ID
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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