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ONTAYA ACEDO LMSW

Individual Provider (NPI-1) Active

Social Worker, Clinical

Provider Information

NPI Number
1104436062
Provider Type
Individual Provider (NPI-1)
Credentials
LMSW
Status
Active

Contact & Location

Address
151 N 3RD AVE STE 330, POCATELLO, ID, 832016369
Phone
(208) 242-3771

Specialties & Taxonomies

Social Worker License: ID #LMSW-39736
Social Worker, Clinical Primary License: ID #8861355

All Addresses

LOCATION

151 N 3RD AVE STE 330

POCATELLO, ID, 832016369

(208) 242-3771

MAILING

151 N 3RD AVE STE 330

POCATELLO, ID, 832016369