Individual
JENNIFER L ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3023 E COPPER POINT DR STE 205, MERIDIAN, ID 83642-9290
(208) 343-7797
Mailing address
11872 N HUMPHREYS WAY, BOISE, ID 83714-9345
(208) 869-9808
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC 4208
ID
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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