Provider Information for 1528363819
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ELIZABETH M MCDOWELL LCSW
Sex: Female
NPI: 1528363819
Last Updated: 2016-03-31
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1528363819 | ||||||||
| Enumeration Date | 2011-01-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 150 SHOUP AVE SUITE 17 IDAHO FALLS, ID 83402 United States Phone: 208-528-5700 | Fax:208-528-5700 | ||||||||
| Primary Practice Address | 2235 E 25TH ST SUITE 160 IDAHO FALLS, ID 83404-7519 United States Phone: 208-528-9812 | Fax:208-528-5747 | ||||||||
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