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Individual

JESSE ALLEN CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
1777 E CLARK ST STE 330, POCATELLO, ID 83201-3357
(208) 478-9081
Mailing address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-41772
ID

Other

Enumeration date
02/09/2022
Last updated
02/09/2022
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