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Individual

MS. DEME DELLAIRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1607 W JEFFERSON ST, BOISE, ID 83702-5111
(208) 336-5533
(208) 947-4290
Mailing address
1607 W JEFFERSON ST, BOISE, ID 83702-5111
(208) 336-5533
(208) 947-4290

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW24873
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010143848
REGENCEBLUESHIELD
ID
01
L2870
BCI
ID
Enumeration date
01/30/2007
Last updated
07/08/2007
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