Individual
TRINA R OMOREFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
25 MIRACLE LN, GARDEN VALLEY, ID 83622-8362
(208) 462-3074
Mailing address
PO BOX 450, GARDEN VALLEY, ID 83622-0450
(208) 462-3074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-34871
ID
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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