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Individual

MS. JENNIFER DEE KERNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
1740 E 17TH ST STE A, IDAHO FALLS, ID 83404-6375
(208) 346-7500
(208) 346-7501
Mailing address
1740 E 17TH ST STE A, IDAHO FALLS, ID 83404-6375
(208) 346-7500
(208) 346-7501

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC 770
ID
101YS0200X
School Counselor
LCPC 770
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144315722
ID
Enumeration date
10/03/2006
Last updated
11/04/2011
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