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General NPI Number Information
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NPI Number | 1861985970
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Entity Type | Individual
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Provider Name | CLARA EARL LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 112 9TH AVE S # B9
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City | NAMPA
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State | ID
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Zip | 83651-3825
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Country | US
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Telephone | 208-825-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 815 8TH ST S
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City | NAMPA
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State | ID
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Zip | 83651-4521
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Country | US
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Telephone | 208-629-6446
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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-41634
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License Number State | ID
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