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1962968636
BRIANNE M FAGENSTROM
BOISE, ID
NPI
1962968636
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LMSW-38329)
Enumeration Date
2019-02-18
Last Update Date
2019-02-18
Business Address
BRIANNE M FAGENSTROM LMSW
1276 W RIVER ST STE 100
BOISE, ID 83702-7083
Phone number: 208-779-6564
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Mailing Address
BRIANNE M FAGENSTROM LMSW
1276 W RIVER ST STE 100
BOISE, ID 83702-7083
Phone number: 208-779-6564
Copy
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