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General NPI Number Information
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NPI Number | 1508268616
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Entity Type | Individual
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Provider Name | ELIZABETH A RUTTEN-TURNER LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 900 N LIBERTY ST SUITE 200
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City | BOISE
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State | ID
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Zip | 83704-8704
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Country | US
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Telephone | 208-367-2126
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Fax | 208-367-4505
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Provider Business Mailing Address
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Address Line | 6533 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-367-8125
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Fax | 208-367-4505
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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 | LMSW33924
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 36350
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License Number State | ID
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