Individual
KATELYN MARIE DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
Mailing address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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