Individual
MRS. JESSICA OWSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2275 W BROADWAY STE G, IDAHO FALLS, ID 83402
(208) 524-7400
Mailing address
2275 W BROADWAY ST STE G, IDAHO FALLS, ID 83402-2902
(208) 524-7400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-35297
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-35297
BUREAU OF OCCUPATIONAL LICENSE DEPARTMENT OF SELF GOVERNING AGENCIES
ID
Enumeration date
10/27/2017
Last updated
07/21/2022
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