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General NPI Number Information
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NPI Number | 1063841369
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Entity Type | Individual
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Provider Name | HILARY COBB LCSW, DSW
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Gender | Female
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 950 W BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83702-5999
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Country | US
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Telephone | 323-205-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 20240 COLEBROOK AVE
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City | CALDWELL
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State | ID
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Zip | 83605-8074
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Country | US
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Telephone | 208-761-7309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-36954
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License Number State | ID
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