Individual
MICHAEL WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
823 HARRISON ST, TWIN FALLS, ID 83301-3925
(208) 736-2177
(208) 736-2113
Mailing address
2074 E 990 S, HAZELTON, ID 83335-5040
(208) 293-4744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-946
ID
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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