Individual
JESSICA GEFRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3525 E LOUISE DR STE 500, MERIDIAN, ID 83642-6305
(208) 706-7050
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
LCSW-40380
ID
Other
Enumeration date
07/16/2019
Last updated
11/07/2023
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