Individual
TED BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3069
(208) 367-3002
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-3069
(208) 367-3002
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW24566
ID
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
About Stedi
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