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Individual

MR. BRADLEY MIDGETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
8590 W FAIRVIEW AVE STE A, BOISE, ID 83704-8320
(208) 672-0260
Mailing address
8590 W FAIRVIEW AVE STE A, BOISE, ID 83704-8320
(208) 559-3319

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW30120
ID

Other

Enumeration date
02/17/2012
Last updated
01/25/2022
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