Individual
MS. KATIE CONLON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2273 S VISTA AVE, SUITE 190, BOISE, ID 83705-7341
(208) 343-2737
Mailing address
2273 S VISTA AVE, SUITE 190, BOISE, ID 83705-7341
(208) 343-2737
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC4643
ID
Other
Enumeration date
01/08/2009
Last updated
05/05/2011
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