Individual
JEFFERY WILLIAM ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
Mailing address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 237-9833
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
08/25/2011
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