Individual
MS. MICHELLE LEJUNE PERRENOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
254 E ST STE B, IDAHO FALLS, ID 83402-3527
(208) 351-7953
(208) 523-5974
Mailing address
254 E ST STE B, IDAHO FALLS, ID 83402-3527
(208) 351-7953
(208) 523-5974
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33241
ID
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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