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1053819300
JACQUELINE A SHAFER
MOUNTAIN HOME AFB, ID
NPI
1053819300
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW40964)
Enumeration Date
2018-01-31
Last Update Date
2023-06-29
Business Address
JACQUELINE A SHAFER LCSW
90 HOPE DR
MOUNTAIN HOME AFB, ID 83648-1057
Phone number: 208-828-7531
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Mailing Address
JACQUELINE A SHAFER LCSW
230 S 13TH EAST STREET
MOUNTAIN HOME, ID 83647
Phone number: 707-295-6223
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