Amy Herzog, LCSW

NPI #1861534133 in Victor, Idaho

Provider Information

NPI Number: 1861534133
Entity Type: Individual
Name: Amy Herzog, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Day Training, Developmentally Disabled Services
Credential: LCSW
Enumeration Date: Feb 13, 2007
Last Updated: Oct 14, 2009

Practice Location

Address: 175 BROME DR.
Address 2: #7
City: Victor
State: Idaho
ZIP Code: 83455
Phone: (406) 360-1631

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Day Training, Developmentally Disabled Services	251C00000X	Primary

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