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General NPI Number Information
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NPI Number | 1588417778
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Entity Type | Organization
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Legal Business Name | THE NEUTRAL AGENCY, LLC
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 14777 W HIGHWAY 53
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City | RATHDRUM
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State | ID
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Zip | 83858-8596
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Country | US
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Telephone | 208-755-1343
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1185
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City | RATHDRUM
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State | ID
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Zip | 83858-1185
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Country | US
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Telephone | 208-755-1343
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MICHELLE J THOMPSON
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Credential | LMSW
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Telephone | 208-755-1343
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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 |
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License Number State |
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