Individual
ZACHARY IVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
459 LOCUST ST N STE 108, TWIN FALLS, ID 83301-7324
(208) 944-8489
Mailing address
188 SOCCORRO DR, JEROME, ID 83338-4932
(208) 404-8373
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-38726
ID
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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