Individual
JENNA WHAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 S ACADEMY AVE, EAGLE, ID 83616-6541
(208) 254-1112
Mailing address
8515 E DROVER LOOP, NAMPA, ID 83687-8506
(208) 505-8657
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
40339
ID
Other
Enumeration date
04/22/2014
Last updated
06/08/2023
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