Individual
ANITA AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW 24219
Contact information
Practice address
209 E LEWIS ST, POCATELLO, ID 83201-6465
(208) 233-7693
Mailing address
209 E LEWIS ST, POCATELLO, ID 83201-6465
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW24219
ID
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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