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Individual

JARED THOMAS JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY

Contact information

Practice address
2001 S WOODRUFF AVE STE 9, IDAHO FALLS, ID 83404-6371
(208) 419-3002
(208) 656-5652
Mailing address
2001 S WOODRUFF AVE STE 9, IDAHO FALLS, ID 83404-6371
(208) 419-3002
(208) 656-5652

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PSY-9671673
ID

Other

Enumeration date
08/22/2025
Last updated
09/12/2025
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