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General NPI Number Information
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NPI Number | 1992426282
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Entity Type | Individual
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Provider Name | MYLA DAY LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 2520 S 5TH AVE
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City | POCATELLO
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State | ID
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Zip | 83204-1923
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Country | US
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Telephone | 208-233-5433
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Fax | 877-284-2783
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Provider Business Mailing Address
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Address Line | 757 S 4TH AVE # B
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City | POCATELLO
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State | ID
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Zip | 83201-6546
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Country | US
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Telephone | 208-351-8703
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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 | LMSW-42588
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License Number State | ID
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