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1124464318
JACKIE L NEWSOM
POCATELLO, ID
NPI
1124464318
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LSW-32514)
Enumeration Date
2013-05-15
Last Update Date
2013-05-15
Business Address
-- JACKIE L NEWSOM LSW
353 N 4TH AVE STE 110
POCATELLO, ID 83201-6390
Phone number: 208-233-7832
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Mailing Address
-- JACKIE L NEWSOM LSW
PO BOX 4908
POCATELLO, ID 83205-4908
Phone number: 208-236-1600
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