Individual
MISTY KLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1720 N WESTGATE DR, SUITE A-1, BOISE, ID 83704-7164
(208) 334-0825
Mailing address
1720 N WESTGATE DR, SUITE A-1, BOISE, ID 83704-7164
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW34973
ID
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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