JACK D NEWSOME

POCATELLO, ID
NPI1124169354
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
(Licence: ID  LCPC 3403)
Enumeration Date2007-02-09
Last Update Date2007-07-09
Business Address
Dr. JACK D NEWSOME Ph.D LCPC
732 WASHINGTON AVE
POCATELLO, ID 83201-3748
Phone number: 208-478-9822
Mailing Address
Dr. JACK D NEWSOME Ph.D LCPC
944 DIXON
IDAHO FALLS, ID 83401
Phone number: 208-478-9822
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