Individual
SUZANNA MARIE BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 ASPEN AVE, SHELLEY, ID 83274-1414
(208) 419-6196
Mailing address
675 ASPEN AVE, SHELLEY, ID 83274-1414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
36378
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-43376
ID
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/08/2017
Last updated
01/28/2025
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