Individual
JANA RAE O'RULLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1069 SUMMERS DR STE B, REXBURG, ID 83440-5335
(208) 681-0647
Mailing address
151 S HIDDEN VALLEY RD, REXBURG, ID 83440-3573
(208) 716-0384
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-36797
ID
Other
Enumeration date
01/23/2018
Last updated
07/06/2021
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