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General NPI Number Information
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NPI Number | 1750552428
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Entity Type | Individual
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Provider Name | AMANDA L MEIERHOFF LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 1001 N 7TH AVE STE 135
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City | POCATELLO
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State | ID
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Zip | 83201-5790
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Country | US
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Telephone | 208-425-2489
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Fax |
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Provider Business Mailing Address
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Address Line | 500 S 11TH AVE STE 400
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City | POCATELLO
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State | ID
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Zip | 83201-4880
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Country | US
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Telephone | 208-232-7862
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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-33006
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License Number State | ID
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