Individual
SARA JEAN HIATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3355 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 523-2080
(208) 523-2799
Mailing address
960 SAFSTROM DR, IDAHO FALLS, ID 83401-4141
(208) 589-0936
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-35545
ID
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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