Individual
MISS TYLAR SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1031 W SANETTA ST, NAMPA, ID 83651-5047
(208) 466-7443
Mailing address
305 S ELM ST APT 210, BOISE, ID 83712-7815
(319) 931-2358
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39664
ID
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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