Individual
SUSAN DEHAAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
451 EASTLAND DR STE 12, TWIN FALLS, ID 83301-7454
(208) 733-0354
(208) 733-0344
Mailing address
451 EASTLAND DR STE 12, TWIN FALLS, ID 83301-7454
(208) 733-0354
(208) 733-0344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCS 9534
CA
1041C0700X
Clinical Social Worker
Primary
LCSW 452
ID
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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