Healthcare Provider Details

I. General information

NPI: 1891752341
Provider Name (Legal Business Name): TORI DAWN TORGRIMSON L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

794 EASTLAND DR
TWIN FALLS ID
83301-6856
US

IV. Provider business mailing address

794 EASTLAND DR
TWIN FALLS ID
83301-6856
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-1281
  • Fax: 208-734-1282
Mailing address:
  • Phone: 208-734-3312
  • Fax: 208-734-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-24446
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: