Individual
JODY OWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCPC
Contact information
Practice address
20 N MAIN ST STE 10, MALAD CITY, ID 83252-1281
(208) 317-6300
(208) 254-3386
Mailing address
20 N MAIN ST STE 10, MALAD CITY, ID 83252-1281
(208) 317-6300
(208) 254-3386
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3275
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806997900
—
ID
Enumeration date
04/18/2007
Last updated
08/19/2022
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