Individual
MELISSA GRYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1276 W RIVER ST, BOISE, ID 83702-7066
(208) 338-4699
Mailing address
PO BOX 8516, BOISE, ID 83707-2516
(208) 703-4750
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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