Individual
HECTOR DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW, CADC
Contact information
Practice address
704 ALBANY ST, CALDWELL, ID 83605-3501
(208) 454-5133
(208) 454-0749
Mailing address
704 ALBANY ST, CALDWELL, ID 83605-3501
(208) 454-5133
(208) 454-0749
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10002
ID
104100000X
Social Worker
Primary
LSW-24218
ID
Other
Enumeration date
09/20/2013
Last updated
09/23/2013
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