Individual
JESSICA MARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2420 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 528-2945
Mailing address
2420 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 528-2945
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-32888
STATE LICENSE
ID
Enumeration date
07/18/2013
Last updated
07/18/2013
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