| NPI | 1528492683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI A ANDERST Provider And Memeber Of LLC 208-965-9094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW32749) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |