NPI | 1902357965 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBORAH ARLENE GOSS Credentialing 208-221-1161 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW 34676) |
Enumeration Date | 2016-10-14 |
Last Update Date | 2023-06-09 |