Individual
DEAN MICHAEL JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
264 BLACK MOUNTAIN RD, BONNERS FERRY, ID 83805-5308
(208) 416-3850
Mailing address
PO BOX 172, BONNERS FERRY, ID 83805-0172
(084) 163-8502
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
41156
ID
1041C0700X
Clinical Social Worker
Primary
4611
MT
Other
Enumeration date
09/12/2013
Last updated
07/13/2023
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