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General NPI Number Information
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NPI Number | 1285443267
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Entity Type | Individual
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Provider Name | URIEL ALEJANDRO CARRANZA LMSW
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Gender | Male
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 560 3RD ST
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City | IDAHO FALLS
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State | ID
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Zip | 83401-3953
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Country | US
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Telephone | 208-529-0169
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Fax | 208-542-5152
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Provider Business Mailing Address
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Address Line | 535 AUBURN AVE
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City | IDAHO FALLS
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State | ID
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Zip | 83401-3703
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Country | US
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Telephone | 208-716-6441
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Fax | 208-542-5152
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMSW-40535
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License Number State | ID
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