| Becky Wolery Enterprises | |
|
250 S Main St Payette ID 83661-2853 | |
| (208) 405-0020 | |
| (208) 739-4425 |
| Full Name | Becky Wolery Enterprises |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 250 S Main St, Payette, Idaho |
| Authorized Official Name and Position | Becky Wolery (OWNER) |
| Authorized Official Contact | 2084050020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Becky Wolery Enterprises Po Box 421 Payette ID 83661-0421 Ph: (208) 405-0020 | Becky Wolery Enterprises 250 S Main St Payette ID 83661-2853 Ph: (208) 405-0020 |
| NPI Number | 1104350511 |
|---|---|
| Provider Enumeration Date | 04/12/2017 |
| Last Update Date | 10/01/2024 |
| Certification Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104350511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L5481 (Oregon) | Secondary |
| 1041C0700X | Social Worker - Clinical | 30777 (Idaho) | Primary |
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