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Individual

AMBER C MOIR-BROW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, ACADC

Contact information

Practice address
30410 HIGHWAY 200, PONDERAY, ID 83852-9601
(208) 946-7333
(208) 625-2066
Mailing address
621 SUGAR MOUNTAIN RD, SANDPOINT, ID 83864-9740
(208) 946-7333
(208) 625-2066

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACADC
ID
104100000X
Social Worker
LCSW-38293
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-38293
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104100000X
SOCIAL WORKER
ID
Enumeration date
11/15/2012
Last updated
06/12/2023
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