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1225863384
JACEY JO MAE LANGSTON
BOISE, ID
NPI
1225863384
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LSW-42591)
Enumeration Date
2024-09-06
Last Update Date
2024-09-06
Business Address
JACEY JO MAE LANGSTON LMSW
148 S COLE RD
BOISE, ID 83709-0932
Phone number: 208-969-8380
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Mailing Address
JACEY JO MAE LANGSTON LMSW
148 S COLE RD
BOISE, ID 83709-0932
Phone number:
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