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1639409188
UNCIL GRACE JO
CALDWELL, ID
NPI
1639409188
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-30053)
Enumeration Date
2010-01-06
Last Update Date
2010-04-01
Business Address
-- UNCIL GRACE JO LCSW
2922 CLEVELAND BLVD STE 500
CALDWELL, ID 83605-6962
Phone number: 208-453-1439
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Mailing Address
-- UNCIL GRACE JO LCSW
11491 W WAGON PASS CT
BOISE, ID 83709-8565
Phone number: 208-345-6202
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