=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972458404
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CECILIA HARMAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2026
-----------------------------------------------------
Last Update Date | 03/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 496 SHOUP AVE W # FT
-----------------------------------------------------
City | TWIN FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83301-5834
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-683-8320
-----------------------------------------------------
Fax | 208-969-8380
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1027 MISTY MEADOWS TRL
-----------------------------------------------------
City | TWIN FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83301-8528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-683-8320
-----------------------------------------------------
Fax | 208-969-8380
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 3061274
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------