Individual
MRS. SUSAN KAY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW28190
Contact information
Practice address
1740 E 17TH ST STE B, IDAHO FALLS, ID 83404-6375
(208) 529-8832
(208) 522-8725
Mailing address
1876 MORAN ST, IDAHO FALLS, ID 83401-4337
(208) 529-0329
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCSW-28190
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149392
BLUE SHIELD
ID
01
—
X5853
BLUE CROSS
ID
Enumeration date
07/27/2006
Last updated
07/09/2007
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