Individual
JENNIFER LEE PRIMROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2311 PARK AVE, STE 12, BURLEY, ID 83318-2170
(208) 678-3555
(208) 678-3556
Mailing address
609 S D ST, RUPERT, ID 83350-2141
(208) 650-8510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-4512
ID
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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