| NPI | 1013223445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A LA JEUNESSE Co Owner 208-283-9121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-28431) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-202425) |
| 103TC0700X Psychologist, Clinical (Licence: ID PSY-202505) | |
| 104100000X Social Worker (Licence: ID LMSW-29787) | |
| 104100000X Social Worker (Licence: ID LMSW-30636) | |
| 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1687) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2015-08-17 |