Individual
JUSTIN JACOBS HACKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1011 W WILLIAMS ST, SUITE G, BOISE, ID 83706-3564
(208) 991-0077
(208) 922-3778
Mailing address
1011 W WILLIAMS ST, SUITE G, BOISE, ID 83706-3564
(208) 991-0770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5125
ID
Other
Enumeration date
02/16/2013
Last updated
04/16/2013
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