Nathan Fauntleroy, LMSW

NPI #1043871668 in Boise, Idaho

Provider Information

NPI Number: 1043871668
Entity Type: Individual
Name: Nathan Fauntleroy, LMSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LMSW
Enumeration Date: Jun 25, 2019
Last Updated: Jun 25, 2019

Practice Location

Address: 1529 BELMONT ST
City: Boise
State: Idaho
ZIP Code: 83706
Phone: (208) 426-1459

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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