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NPI Code Detail

MEDICARE: EMILY WETTSTEIN

MEDICARE: EMILY WETTSTEIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerLMSW-32207ID

General Provider Information

NPI Number : 1619399011
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY WETTSTEIN
Provider Business Mailing Address
First Line : 417 S 6TH ST
Second Line :
City : BOISE
State : ID
Zip : 83702-7632
Country : US
Telephone Number : 208-577-4460
Fax Number :
Provider Business Practice Location Address
First Line : 417 S 6TH ST
Second Line :
City : BOISE
State : ID
Zip : 83702-7632
Country : US
Telephone Number : 208-577-4460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2014
Last Update Date : 01/20/2014

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Directions to “ EMILY WETTSTEIN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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