| NPI | 1811778673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA R. CROCKER-OSWALD Clinical Social Worker 208-392-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-07-08 |