Individual
MRS. JENNIFER CERVANTES SHUFFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2606 GRANVILLE ST, MOSCOW, ID 83843-5002
(208) 874-2409
Mailing address
2606 GRANVILLE ST, MOSCOW, ID 83843-5002
(208) 874-2409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-28718
ID
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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