Individual
MS. ANNA RENE JUNGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,CADC
Contact information
Practice address
1015 S MAIN STREET, RIGGINS, ID 83549
(208) 816-6958
Mailing address
PO BOX 433, 306 MAIN STREET #3, RIGGINS, ID 83549-1483
(208) 816-6958
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCSW-29069
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
2012-267
ID
101YP2500X
Professional Counselor
LCSW-29069
ID
1041C0700X
Clinical Social Worker
LCSW-29069
ID
Other
Enumeration date
01/12/2012
Last updated
05/04/2017
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