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Individual

MR. CLAY S TUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
4477 W EMERALD ST, BOISE, ID 83706-2000
(208) 376-9831
Mailing address
4477 W EMERALD ST, BOISE, ID 83706-2000
(208) 376-9831

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
32194
ID

Other

Enumeration date
06/05/2015
Last updated
06/05/2015
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