Individual
MR. MICHAEL CHARLES BOTNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
118 NORTH 7TH STREET SUITE B-12, COEUR D' ALENE, ID 83814
(208) 667-6606
Mailing address
118 NORTH 7TH STREET SUITE B-12, COEUR D' ALENE, ID 83814
(208) 667-6606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW11
ID
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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