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Individual

PATTI MATHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
Mailing address
480 TABOR AVE, IDAHO FALLS, ID 83401-2941
(208) 680-2381

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW2662
ID

Other

Enumeration date
06/17/2014
Last updated
06/17/2014
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Product
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  • EDI platform