Individual
JEREMY J STOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
915 PARKCENTRE WAY STE 7, NAMPA, ID 83651-1748
(208) 442-7791
(208) 442-7792
Mailing address
915 PARKCENTRE WAY STE 7, NAMPA, ID 83651-1748
(208) 442-7791
(208) 442-7792
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-30969
ID
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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