WADE DARREN LEAVITT

IDAHO FALLS, ID
NPI1275015422
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: ID  LMSW-37989)
Enumeration Date2018-09-04
Last Update Date2018-09-04
Business Address
WADE DARREN LEAVITT LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-861-2093
Mailing Address
WADE DARREN LEAVITT LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-861-2093
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