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1386780161
KENNETH CRAIG MINNIX
IDAHO FALLS, ID
NPI
1386780161
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-434)
Enumeration Date
2007-01-29
Last Update Date
2007-07-08
Business Address
-- KENNETH CRAIG MINNIX LCSW
1600 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401-4300
Phone number: 208-529-5276
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Mailing Address
-- KENNETH CRAIG MINNIX LCSW
1600 JOHN ADAMS PKWY
IDAHO FALLS, ID 83401-4300
Phone number: 208-529-5276
Copy
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