Individual
SHANNON R KERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
493 EASTLAND DR, TWIN FALLS, ID 83301-7441
(208) 410-4866
Mailing address
2818 SUNRAY LOOP, TWIN FALLS, ID 83301-6700
(208) 410-4866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3558
SD
1041C0700X
Clinical Social Worker
8005634-3501
UT
1041C0700X
Clinical Social Worker
Primary
LCSW-37496
ID
Other
Enumeration date
07/11/2016
Last updated
08/19/2019
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