JO ANNA SHOTIVEYARATANA

POCATELLO, ID
NPI1104424191
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YS0200X Counselor, School
(Licence: ID  LPC-7837)
Enumeration Date2020-10-13
Last Update Date2020-10-13
Business Address
JO ANNA SHOTIVEYARATANA MA, LPC
707 W WYETH ST
POCATELLO, ID 83204-3058
Phone number: 208-240-3799
Mailing Address
JO ANNA SHOTIVEYARATANA MA, LPC
707 W WYETH ST
POCATELLO, ID 83204-3058
Phone number: 208-240-3799
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