Tyson Daniels, LCSW

NPI #1487189163 in Malad City, Idaho

Provider Information

NPI Number: 1487189163
Entity Type: Individual
Name: Tyson Daniels, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: May 1, 2017
Last Updated: May 1, 2017

Practice Location

Address: 150 N 200 W
City: Malad City
State: Idaho
ZIP Code: 83252-1239
Phone: (208) 766-2231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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