Individual
JILL M STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
265 E CHUBBUCK RD, CHUBBUCK, ID 83202-5055
(208) 237-1711
(208) 237-9806
Mailing address
1280 APPLE ORCHARD DR, POCATELLO, ID 83204-7323
(509) 949-5908
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-40171
ID
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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