Individual
JODI HICKENLOOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1502 W FRANKLIN ST, BOISE, ID 83702-4028
(208) 860-5131
Mailing address
1120 W OFARRELL ST, BOISE, ID 83702-4147
(208) 860-5131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3678
ID
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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