Individual
JASON KENDALL POPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4825 ALDER CREEK RD, SAINT MARIES, ID 83861-9765
(208) 568-0826
(208) 665-5795
Mailing address
4825 ALDER CREEK RD, SAINT MARIES, ID 83861-9765
(208) 568-0826
(208) 665-5795
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-37223
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366794224
—
ID
Enumeration date
01/30/2018
Last updated
01/30/2018
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