Individual
ADETTA D UMPHENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6615 COMANCHE STREET, BONNERS FERRY, ID 83805
(208) 267-1718
(208) 267-9197
Mailing address
6615 COMANCHE STREET, BONNERS FERRY, ID 83805
(208) 267-1718
(208) 267-9197
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-39945
ID
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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