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1104685460
MYLES NELSON
BOISE, ID
NPI
1104685460
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LMSW-44521)
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
MYLES NELSON LMSW
410 S ORCHARD ST STE 184
BOISE, ID 83705-1293
Phone number: 208-214-7408
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Mailing Address
MYLES NELSON LMSW
3841 W NEWLAND ST
MERIDIAN, ID 83642-5197
Phone number: 916-517-6896
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