NPI 1114388105

Sadie Green

Practitioner Clinical Social Worker Ponderay, ID

Practice location

Address: 207 Larkspur St, Ponderay, ID 83852-5011
Phone: (208) 255-3334
Mailing address: 514 N Sixth Ave, Sandpoint, ID 83864-1525

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence LCSW-35936 (ID)

Other Social Worker providers in Idaho →

Registry record

NPI: 1114388105
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Mar 2016
Record last updated: 27 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.