YVETTE LISA JACKSON

BOISE, ID
NPI1063927853
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-37582)
Additional Taxonomies104100000X Social Worker
(Licence: ID  LMSW-33944)
Enumeration Date2017-12-03
Last Update Date2019-07-19
Business Address
YVETTE LISA JACKSON LCSW
223 N 6TH ST STE 230
BOISE, ID 83702-5954
Phone number: 208-991-4696
Mailing Address
YVETTE LISA JACKSON LCSW
11421 W KINGS CANYON CT
BOISE, ID 83709-7940
Phone number: