Individual
CORY EVAN PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
Mailing address
1256 AZALEA DR, IDAHO FALLS, ID 83404-6145
(208) 317-1741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-36995
ID
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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