KATHY MATLOCK TIDWELL

BOISE, ID
NPI1083767131
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW 858)
Enumeration Date2007-01-20
Last Update Date2019-09-16
Business Address
Ms. KATHY MATLOCK TIDWELL LCSW
5999 W STATE ST STE B
BOISE, ID 83703-3039
Phone number: 208-853-5095
Mailing Address
Ms. KATHY MATLOCK TIDWELL LCSW
7285 W FRANKLIN RD
BOISE, ID 83709-0926
Phone number: 208-853-5095