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General NPI Number Information
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NPI Number | 1508251588
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Entity Type | Organization
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Legal Business Name | DUSTIN MAYS, LMSW, PLLC
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 684 N 9TH ST B
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City | BOISE
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State | ID
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Zip | 83702-5458
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Country | US
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Telephone | 208-284-6243
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Fax |
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Provider Business Mailing Address
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Address Line | 684 N 9TH ST B
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City | BOISE
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State | ID
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Zip | 83702-5458
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWER
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Name | DUSTIN MAYS
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Credential | LMSW
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Telephone | 208-284-6243
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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 | LMSW- 34638
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License Number State | ID
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