| NPI | 1336466994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KAY BOOTHE Biller 208-765-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ID LCSW29348) |
| Enumeration Date | 2010-04-22 |
| Last Update Date | 2010-04-22 |