Basic Information
| Provider Information | |||||||||
| NPI: | 1710288014 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TORREZ | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | NOEL | ||||||||
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| Credential: | MS, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2488 W WASHINGTON AVE | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | NAMPA | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836862677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082879420 | ||||||||
| FaxNumber: | 2082879426 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 12TH AVE S | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | NAMPA | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836513952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083508998 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2010 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW-30219 | ID | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.