Individual
JODI WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8100 W EMERALD ST STE 150, AFFINITY INC, BOISE, ID 83704-9057
(208) 375-0752
(208) 345-5534
Mailing address
1065 W PINE AVE APT 1, MERIDIAN, ID 83642-8389
(208) 841-8011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-29875
ID
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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