Individual
MARY A HAMERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.,L.C.S.W.
Contact information
Practice address
500 W. FORT, BOISE, ID 83702
(208) 422-1000
Mailing address
680 TROUTNER WAY, BOISE, ID 83712
(208) 386-9300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-624
ID
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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