Individual
ERIC DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8620 W EMERALD ST STE 150, BOISE, ID 83704-4839
(208) 305-5261
Mailing address
4636 S DENISON AVE, MERIDIAN, ID 83642-9201
(208) 305-5261
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33942
ID
Other
Enumeration date
02/07/2015
Last updated
02/07/2015
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