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General NPI Number Information
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NPI Number | 1386770741
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Entity Type | Individual
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Provider Name | DALE ALLEN SCHNEIDER LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1675 CURLEW DR.
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City | AMMON
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State | ID
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Zip | 83406
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Country | US
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Telephone | 208-529-4300
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Fax | 208-529-1627
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Provider Business Mailing Address
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Address Line | 7419 S 25TH E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7760
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Country | US
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Telephone | 208-528-7232
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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-26743
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License Number State | ID
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