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Individual

TERI LEE WILSKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
845 BARTON RD TRLR 35, POCATELLO, ID 83204-1827
(208) 240-8540
Mailing address
845 BARTON RD TRLR 35, POCATELLO, ID 83204-1827
(208) 240-8540

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-27997
ID

Other

Enumeration date
02/19/2020
Last updated
02/19/2020
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