Individual
CARY IMESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2057 E HIDDEN COVE LN, EAGLE, ID 83616-7640
(208) 724-8486
Mailing address
2057 E HIDDEN COVE LN, EAGLE, ID 83616-7640
(208) 724-8486
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW33065
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-37608
ID
Other
Enumeration date
03/06/2013
Last updated
05/14/2024
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