Individual
JASON A CAMPAGNONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1021 W HEMINGWAY BLVD, NAMPA, ID 83651-1763
(401) 499-3168
Mailing address
1021 W HEMINGWAY BLVD, NAMPA, ID 83651-1763
(401) 499-3168
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1061376
ID
101YM0800X
Mental Health Counselor
MHC00066-A
RI
Other
Enumeration date
06/24/2024
Last updated
08/15/2024
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