Provider Demographics
NPI:1891244455
Name:GIARD, ALICE (LMSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:GIARD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6191 N BANDON PL
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:ID
Mailing Address - Zip Code:83714-4057
Mailing Address - Country:US
Mailing Address - Phone:208-629-5468
Mailing Address - Fax:
Practice Address - Street 1:1550 N CRESTMONT DR
Practice Address - Street 2:STE A
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2184
Practice Address - Country:US
Practice Address - Phone:208-288-4200
Practice Address - Fax:208-288-4279
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID33616104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker