MATTHEW J WADSWORTH

FORT HALL, ID
NPI1972759017
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-31281)
Enumeration Date2008-08-08
Last Update Date2013-01-09
Business Address
-- MATTHEW J WADSWORTH LCSW
717 MISSION ROAD
FORT HALL, ID 83203-0306
Phone number: 208-237-5631
Mailing Address
-- MATTHEW J WADSWORTH LCSW
PO BOX 306
FORT HALL, ID 83203-0306
Phone number: 208-237-5631
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