is a Clinical in Twin Falls, Idaho. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1215194121. The last update date is .
's current location address is 794 Eastland Dr, Twin Falls, Idaho. You can contact this provider via phone number 2087376718. The mailing address for is 794 Eastland Dr, Twin Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 794 Eastland Dr, Twin Falls, Idaho |
| Phone Number | 2087376718 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1215194121 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 794 Eastland Dr |
|---|---|
| City | Twin Falls |
| State | Idaho (ID) |
| Post Code | 833016856 |
| Phone Number | 2087376718 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCSW-38761 |
|
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 260022408 | UT | RAILROAD MEDICARE | |
| 876000308007 | UT | -- |
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