LUIS ESTEBAN CHAVOLLA
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1902372857- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 3700 W SELTICE WAY, COEUR D ALENE, ID, 838148921
- Phone
- (208) 620-5250
Specialties & Taxonomies
Social Worker
License: ID #LMSW-43041
Social Worker, Clinical
Primary License: ID #8911211