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Individual

MS. VICTORIA L MECHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
320 B ST STE 109, IDAHO FALLS, ID 83402-3547
(208) 528-5434
(208) 522-4364
Mailing address
118 S STOUT AVE, BLACKFOOT, ID 83221-2943
(208) 785-5810
(208) 522-4364

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-25042
ID

Other

Enumeration date
11/07/2013
Last updated
11/07/2013
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