Individual
CRESCENTIA HILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
111 BEVER GRADE, LAPWAI, ID 83540-0367
(208) 843-2271
Mailing address
PO BOX 367, LAPWAI, ID 83540-0367
(208) 843-2271
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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