Individual
JOAN LYNN COLOMBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
241 ATLANTIC AVE, MIDDLETON, ID 83644-5863
(208) 861-4447
Mailing address
241 ATLANTIC AVE, MIDDLETON, ID 83644-5863
(208) 861-4447
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-34635
ID
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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