Individual
MS. JEANNETTE M SAPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW/ CADC
Contact information
Practice address
303 N 12TH AVE, 204, POCATELLO, ID 83201-4746
(208) 604-3282
Mailing address
607 N 1200 W, BLACKFOOT, ID 83221-5171
(208) 604-3282
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1042003
ID
1041C0700X
Clinical Social Worker
Primary
LMSW-28500
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10400000X
—
ID
Enumeration date
05/29/2008
Last updated
05/29/2008
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