Individual
EMILY SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1218 BOND AVE, REXBURG, ID 83440-3503
(208) 534-7881
(208) 242-4464
Mailing address
PO BOX 1407, IDAHO FALLS, ID 83403-1407
(801) 518-4929
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
8861741
ID
Other
Enumeration date
05/01/2019
Last updated
10/29/2024
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