Organization
JESSE TANGEN LCSW COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE TANGEN LCSW (OWNER)
(701) 893-8828
Entity
Organization
Contact information
Practice address
410 S ORCHARD ST STE 124, BOISE, ID 83705-1210
(701) 893-8828
Mailing address
410 S ORCHARD ST STE 124, BOISE, ID 83705-1210
(701) 893-8828
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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