Individual
KATIE ROSE MOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSA
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
5301 S COMMANCHE CIR, BOISE, ID 83709-5706
(208) 921-9101
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
39621
ID
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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