Individual
MRS. JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3067 E COPPER POINT DR, MERIDIAN, ID 83642-1740
(208) 888-1758
Mailing address
10421 W BROWNSTONE DR, BOISE, ID 83709-5612
(208) 794-8240
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LMSW-29066
ID
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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