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General NPI Number Information
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NPI Number | 1972032340
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Entity Type | Individual
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Provider Name | YANETH ORELLANA ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 2275 S EAGLE RD STE 120
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City | MERIDIAN
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State | ID
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Zip | 83642-2620
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Country | US
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Telephone | 208-514-2520
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Fax | 208-375-2217
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Provider Business Mailing Address
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Address Line | 777 N RAYMOND ST
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City | BOISE
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State | ID
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Zip | 83704-9251
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Country | US
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Telephone | 208-514-2500
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Fax | 208-375-2217
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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-42452
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License Number State | ID
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