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General NPI Number Information
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NPI Number | 1982586558
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Entity Type | Individual
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Provider Name | MOLLIE SMOLKOWSKI LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1901 N LAKES PL STE 150
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City | MERIDIAN
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State | ID
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Zip | 83646-5939
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Country | US
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Telephone | 208-890-7165
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 W TOBI DR
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City | BOISE
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State | ID
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Zip | 83714-2427
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Country | US
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Telephone | 208-409-3771
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 3871168
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License Number State | ID
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