Individual
LAURA PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
586 1ST ST, IDAHO FALLS, ID 83401-3963
(208) 529-2920
Mailing address
340 MOONLITE DR APT 4, IDAHO FALLS, ID 83402-2343
(208) 403-6456
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-27649
ID
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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