Individual
MS. HEATHER KATHLEEN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2300 N 26TH ST, BOISE, ID 83702-0231
(208) 371-6841
Mailing address
2300 N 26TH ST, BOISE, ID 83702-0231
(208) 371-6841
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-31747
ID
Other
Enumeration date
04/08/2008
Last updated
02/16/2017
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