Organization
SEASONS OF HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATH JACOB SOMMER PH.D. (CEO)
(208) 237-9833
Entity
Organization
Contact information
Practice address
4650 HAWTHORNE RD, CHUBBUCK, ID 83202-2376
(208) 237-9833
(208) 237-1800
Mailing address
4650 HAWTHORNE RD, CHUBBUCK, ID 83202-2376
(208) 237-9833
(208) 237-1800
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY202423
ID
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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