Individual
JENNIFER RYAN ZACCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD,LPC
Contact information
Practice address
634 CARRIAGE LN, TWIN FALLS, ID 83301-6839
(208) 404-9409
Mailing address
634 CARRIAGE LN, TWIN FALLS, ID 83301-6839
(208) 404-9409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6217
ID
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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