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1063892750
SHANDRA BLACKER
IDAHO FALLS, ID
NPI
1063892750
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID 34857)
Enumeration Date
2015-06-08
Last Update Date
2015-06-08
Business Address
-- SHANDRA BLACKER LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
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Mailing Address
-- SHANDRA BLACKER LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
Copy
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