Individual
SHANNON MARIE MORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-3901
Mailing address
10888 W HIGHLANDER RD, BOISE, ID 83709-5241
(208) 447-7788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
37607
ID
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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