Individual
MR. RAYMOND JOSEPH PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
427 12TH ST, PLUMMER, ID 83851-4000
(208) 686-1931
Mailing address
5452 N STUART ST, COEUR D ALENE, ID 83815-9492
(208) 661-3054
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-42383
ID
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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