Individual
LINDA CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
427 N MAIN ST STE 101, POCATELLO, ID 83204-3016
(208) 705-0771
Mailing address
1140 N MINK CREEK RD, POCATELLO, ID 83204-7250
(208) 705-0771
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-28640
ID
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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