Individual
NIKKI LYN BERRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 523-3857
(208) 523-3876
Mailing address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404
(208) 523-3857
(208) 523-3876
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
8082877-3501
UT
1041C0700X
Clinical Social Worker
Primary
LCSW-34679
ID
Other
Enumeration date
09/22/2010
Last updated
11/10/2016
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