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1083001630
JESSE RAY COBB
FRUITLAND, ID
NPI
1083001630
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-30921)
Enumeration Date
2015-04-21
Last Update Date
2015-04-21
Business Address
Mr. JESSE RAY COBB LCSW
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-8600
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Mailing Address
Mr. JESSE RAY COBB LCSW
1210 NW 16TH ST
FRUITLAND, ID 83619-2202
Phone number: 208-452-8600
Copy
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