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1477219061
STACI SUTHERLAND
IDAHO FALLS, ID
NPI
1477219061
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Former Name
STACI CLAVER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID 39337)
Enumeration Date
2021-11-09
Last Update Date
2022-04-22
Business Address
STACI SUTHERLAND LMSW
180 N WOODRUFF AVE
IDAHO FALLS, ID 83401-4335
Phone number: 208-346-0688
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Mailing Address
STACI SUTHERLAND LMSW
180 N WOODRUFF AVE
IDAHO FALLS, ID 83401-4335
Phone number: 208-346-0688
Copy
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