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Individual

JUSTIN EASTLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
22480 DUFF LN, MIDDLETON, ID 83644-6041
(310) 903-6814
Mailing address
10712 W CRUSER DR, BOISE, ID 83709-0209
(310) 903-6814

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ID

Other

Enumeration date
09/30/2024
Last updated
09/30/2024
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