Individual
MR. THOMAS E. TUELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2275 W BROADWAY ST STE G, IDAHO FALLS, ID 83402-2902
(208) 524-7400
(208) 524-8004
Mailing address
2275 W BROADWAY ST STE G, IDAHO FALLS, ID 83402-2902
(208) 524-7400
(208) 524-8004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-859
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740321314
—
ID
Enumeration date
02/08/2007
Last updated
05/09/2022
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