Individual
JAKOB KAMILOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7297
Mailing address
90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648-1062
(208) 828-7580
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
011367
CT
Other
Enumeration date
06/01/2016
Last updated
03/07/2022
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