Individual
JENNIFER BUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 S MAIN ST, POCATELLO, ID 83204-3210
(208) 221-1027
Mailing address
101 S MAIN ST, POCATELLO, ID 83204-3210
(208) 221-1027
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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