Individual
MRS. MARY JANE CONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
518 LINDEN DR, LEWISTON, ID 83501-4432
(208) 746-4025
Mailing address
518 LINDEN DR, LEWISTON, ID 83501-4432
(208) 746-4025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW28430
ID
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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