Individual
JACOB ATKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, ATR
Contact information
Practice address
671 E RIVERPARK LN STE 220, BOISE, ID 83706-6559
(208) 344-2071
Mailing address
6568 S FEDERAL WAY, BOX 235, BOISE, ID 83716-9277
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
5800
ID
103TC1900X
Counseling Psychologist
Primary
PSY-203023
ID
Other
Enumeration date
01/18/2011
Last updated
07/06/2022
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