Individual
ALICIA JO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
265 E CHUBBUCK RD, CHUBBUCK, ID 83202-5055
(208) 237-1711
(208) 237-9806
Mailing address
265 E CHUBBUCK RD, CHUBBUCK, ID 83202-5055
(208) 237-1711
(208) 237-9806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8911078
ID
Other
Enumeration date
12/06/2022
Last updated
04/23/2025
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