Individual
COURTNEY JENSEN MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
190 WEST MAIN STREET, KUNA, ID 83634
(208) 922-9001
(208) 922-3778
Mailing address
1914 N SUMMERWIND PL, KUNA, ID 83634-3463
(208) 922-9001
(208) 922-3778
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-25827
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L4785
BLUE CROSS OF IDAHO
ID
Enumeration date
10/20/2006
Last updated
07/08/2007
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