Individual
SONNIE L JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 1ST ST E, HANSEN, ID 83334-4917
(208) 423-5779
Mailing address
409 1ST ST E, HANSEN, ID 83334-4917
(208) 423-5779
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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