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MR. ALEXI DIMITRIOS FANOPOULOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
3076 N FIVE MILE RD, BOISE, ID 83713-5215
(208) 376-4999
Mailing address
3076 N FIVE MILE RD, BOISE, ID 83713-5215
(208) 376-4999

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-41913
ID

Other

Enumeration date
03/08/2022
Last updated
03/08/2022
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