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1043871668
NATHAN FAUNTLEROY
BOISE, ID
NPI
1043871668
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: ID 38789)
Enumeration Date
2019-06-25
Last Update Date
2019-06-25
Business Address
NATHAN FAUNTLEROY LMSW
1529 BELMONT ST
BOISE, ID 83706
Phone number: 208-426-1459
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Mailing Address
NATHAN FAUNTLEROY LMSW
1247 S DIVISION AVE
BOISE, ID 83706-3652
Phone number: 317-755-6008
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