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1447294004
DONEVAN B NEIDER
IDAHO FALLS, ID
NPI
1447294004
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-27313)
Enumeration Date
2006-06-15
Last Update Date
2009-05-06
Business Address
-- DONEVAN B NEIDER LCSW
1522 ELK CREEK DRIVE
IDAHO FALLS, ID 83404
Phone number: 208-552-0920
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Mailing Address
-- DONEVAN B NEIDER LCSW
1522 ELK CREEK DRIVE
IDAHO FALLS, ID 83404
Phone number: 208-552-0920
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