Individual
MISS JORDYN DOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-INTERN
Contact information
Practice address
141 CITATION WAY, HAILEY, ID 83333-5103
(904) 945-0781
Mailing address
PO BOX 3663, KETCHUM, ID 83340-3500
(904) 945-0781
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
COUI-7015
ID
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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