Individual
CALLAE RENE' MARCELLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
647 FILER AVE, TWIN FALLS, ID 83301-4008
(208) 737-9999
Mailing address
647 FILER AVE, TWIN FALLS, ID 83301-4008
(208) 737-9999
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-27631
ID
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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