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General NPI Number Information
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NPI Number | 1285062109
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Entity Type | Individual
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Provider Name | JANET NAOMI STELLWAY LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/31/2013
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 323 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-5014
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Country | US
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Telephone | 208-463-0212
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Fax | 208-461-5452
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Provider Business Mailing Address
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Address Line | 323 12TH AVE RD
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City | NAMPA
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State | ID
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Zip | 83686-5014
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Country | US
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Telephone | 208-463-0212
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Fax | 208-461-5452
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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 | LMSW30500
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License Number State | ID
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