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Individual

MICHELLE POLMANTEER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW, ICADC

Contact information

Practice address
1125 E POLSTON AVE STE A, POST FALLS, ID 83854-6045
(208) 457-1540
Mailing address
1125 E POLSTON AVE STE A, POST FALLS, ID 83854-6045
(208) 457-1540

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10247
ID
104100000X
Social Worker
LSW-2717
ID

Other

Enumeration date
05/07/2015
Last updated
05/07/2015
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