Individual
MS. JAN EILENE SHAUGHNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
226 S COLE RD, BOISE, ID 83709-0934
(208) 376-3677
(208) 376-3730
Mailing address
226 S. COLE RD, BOISE, ID 83709
(208) 376-3677
(208) 376-3730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW27207
ID
Other
Enumeration date
03/10/2008
Last updated
05/04/2012
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