| Doctor Name: | MS. PATRECE ELISABETH MOODY MEZA |
| NPI Number: | 1649250564 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 457 |
| Business Practice Address: | 190 W. Main Street Kuna, ID - 836340959 |
| Business Phone Number: | 2087331996 |
| Business Fax Number: | |
| Mailing Address: | Po Box 959, 190 W. Main Street Kuna Counseling Center KUNA |
| State: | ID |
| Postal Code: | 836340959 |
| Phone Number: | 2089229001 |
| Fax Number: | 2089223778 |
| NPI Enumeration Date: | 01/18/2006 |
| NPI Last Update Date: | 10/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 457 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |