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General NPI Number Information
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NPI Number | 1245191717
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Entity Type | Individual
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Provider Name | BAYLEE LOUISE SANDERSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1191 E IRON EAGLE DR STE 100
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City | EAGLE
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State | ID
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Zip | 83616-5139
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Country | US
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Telephone | 208-805-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 9153 W CANNEL ISLAND ST
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City | BOISE
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State | ID
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Zip | 83709-8223
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Country | US
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Telephone | 986-226-9218
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | ID
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