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1366847428
DANIEL JEROME HALL
FORT HALL, ID
NPI
1366847428
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW30964)
Enumeration Date
2014-10-30
Last Update Date
2014-10-30
Business Address
-- DANIEL JEROME HALL LCSW
717 MISSION ROAD
FORT HALL, ID 83203
Phone number: 208-237-5631
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Mailing Address
-- DANIEL JEROME HALL LCSW
PO BOX 306
FORT HALL, ID 83203-0306
Phone number: 208-237-5631
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