DAN TADLOCK

BONNERS FERRY, ID
NPI1124397476
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-29379)
Enumeration Date2011-12-15
Last Update Date2011-12-15
Business Address
-- DAN TADLOCK LCSW
6883 FRESNO ST
BONNERS FERRY, ID 83805-8556
Phone number: 208-946-7005
Mailing Address
-- DAN TADLOCK LCSW
6883 FRESNO ST
BONNERS FERRY, ID 83805-8556
Phone number: 208-946-7005
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