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1770618712
TED BURGESS
BOISE, ID
NPI
1770618712
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID SW24566)
Enumeration Date
2007-02-22
Last Update Date
2007-07-08
Business Address
-- TED BURGESS LCSW
1055 N CURTIS RD
BOISE, ID 83706-1309
Phone number: 208-367-3069
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Mailing Address
-- TED BURGESS LCSW
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-367-3069
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