Organization
JACKIE NELSON, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN NELSON M.S.C, LCPC (OWNER AND COUNSELOR)
(480) 316-5462
Entity
Organization
Contact information
Practice address
202 N 9TH ST STE 401C, BOISE, ID 83702-5770
(208) 639-9192
Mailing address
4621 W KENDALL ST, BOISE, ID 83706-2222
(480) 316-5462
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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