| NPI | 1962640714 |
|---|---|
| Other Name | LARA REINECKE |
| Entity Type | Organization |
| Authorized Contact | LARA E. REINECKE Clinical Social Worker 208-484-9792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SD 2354) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |