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Individual

JEREMIAH OSBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSW

Contact information

Practice address
921 S ORCHARD ST STE 101, BOISE, ID 83705-1916
(208) 629-2436
(208) 712-6778
Mailing address
921 S ORCHARD ST STE 101, BOISE, ID 83705-1916
(208) 420-3018
(208) 712-6778

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-38962
ID

Other

Enumeration date
02/11/2020
Last updated
02/11/2020
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