Individual
JORDAN LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1309 CAMAS ST, BLACKFOOT, ID 83221-3060
(208) 782-0675
Mailing address
1309 CAMAS ST, BLACKFOOT, ID 83221-3060
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-8851783
ID
Other
Enumeration date
10/15/2017
Last updated
07/29/2025
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