Individual
SHIRLYNN MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
524 CLEVELAND BLVD STE 230, CALDWELL, ID 83605-4080
(208) 454-9054
Mailing address
524 E. CLEAVLAND BLVD, SUITE #230, CALDWELL, ID 83605
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW 31345
ID
Other
Enumeration date
04/18/2013
Last updated
04/18/2013
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