Individual
WENDY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
60 N BROADWAY ST, BLACKFOOT, ID 83221-2706
(208) 782-3434
(208) 782-1389
Mailing address
60 N BROADWAY ST, PO BOX 1472, BLACKFOOT, ID 83221-2706
(208) 782-3434
(208) 782-1389
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-25124
ID
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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