Individual
BARRY EDWARD JENKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
2280 AMERICAN LEGION BLVD, MOUNTAIN HOME, ID 83647-3142
(208) 366-7416
Mailing address
PO BOX 266, GLENNS FERRY, ID 83623-0266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-4573
ID
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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