STACY RAE TOLLIVER

BOISE, ID
NPI1114290269
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW 1001)
Enumeration Date2012-02-21
Last Update Date2012-02-21
Business Address
Ms. STACY RAE TOLLIVER LCSW
3712 GREENBRIER DR
BOISE, ID 83705-4517
Phone number: 208-949-0004
Mailing Address
Ms. STACY RAE TOLLIVER LCSW
3712 GREENBRIER DR
BOISE, ID 83705-4517
Phone number: 208-949-0004
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