KENNETH DALE WIDICK LMSW
Individual Provider (NPI-1)
Active
Social Worker
Provider Information
- NPI Number
1538088331- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LMSW
- Status
- Active
Contact & Location
- Address
- 305 E 37TH ST, GARDEN CITY, ID, 837146419
- Phone
- (208) 331-0900
- Fax
- (208) 331-0904
Specialties & Taxonomies
Social Worker
Primary License: ID #LMSW-31550