Individual
DR. JAY WESLEY WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2995 N COLE RD, BOISE, ID 83704-5964
(208) 376-0453
(208) 376-0477
Mailing address
2995 N COLE RD, BOISE, ID 83704-5964
(208) 376-0453
(208) 376-0477
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-360
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010145911
RBSI PROVIDER ID
ID
01
—
N4494
BC OF IDAHO PROVIDER ID
ID
Enumeration date
03/03/2007
Last updated
07/08/2007
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