Individual
JODI HYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 S UTAH AVE STE 356, IDAHO FALLS, ID 83402-3334
(208) 541-4295
Mailing address
34 N 3600 E, RIGBY, ID 83442-5638
(208) 541-4295
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAC-15121
AZ
101Y00000X
Counselor
LPC-17984
AZ
101YM0800X
Mental Health Counselor
340782-6004
UT
101YP2500X
Professional Counselor
Primary
LPC-7875
ID
Other
Enumeration date
10/23/2014
Last updated
10/06/2021
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