Individual
MRS. JENNA NICOLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 S 11TH AVE, SUITE 303, POCATELLO, ID 83201-4835
(208) 239-3815
(208) 239-3814
Mailing address
500 S 11TH AVE, SUITE 303, POCATELLO, ID 83201-4835
(208) 239-3815
(208) 239-3814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-38005
ID
Other
Enumeration date
02/15/2017
Last updated
09/12/2018
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