Individual
JACI EREN URIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
630 ADDISON AVE W, TWIN FALLS, ID 83301-5491
(208) 736-5048
Mailing address
630 ADDISON AVE W, TWIN FALLS, ID 83301-5491
(208) 736-5048
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-24440
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558606962
—
ID
Enumeration date
07/23/2013
Last updated
11/23/2020
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