PRISCILLA SHARON-GEORGIA BAKE

HAILEY, ID
NPI1770225112
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  8861956)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: ID  LMSW-42222)
104100000X Social Worker
(Licence: ID  LSW-40865)
104100000X Social Worker
(Licence: ID  LMSW-42222)
Enumeration Date2022-04-07
Last Update Date2024-12-03
Business Address
PRISCILLA SHARON-GEORGIA BAKE LMSW
1450 AVIATION DR
HAILEY, ID 83333-8785
Phone number: 208-727-8970
Mailing Address
PRISCILLA SHARON-GEORGIA BAKE LMSW
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: