STACEY TITUS

BOISE, ID
NPI1801244843
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: ID  LMSW - 35801)
Enumeration Date2016-06-01
Last Update Date2016-06-01
Business Address
-- STACEY TITUS L.M.S.W
11868 W GUNSMOKE DR
BOISE, ID 83713-4753
Phone number: 208-860-2656
Mailing Address
-- STACEY TITUS L.M.S.W
11868 W GUNSMOKE DR
BOISE, ID 83713-4753
Phone number: 208-860-2656
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