Individual
GARREN RICHARD AUBREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
210 W BURNSIDE AVE STE A, POCATELLO, ID 83202-4916
(208) 238-9000
(208) 238-9002
Mailing address
210 W BURNSIDE AVE STE A, POCATELLO, ID 83202-4916
(208) 238-9000
(208) 238-9002
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW35148
ID
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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