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1407284698
JEFFERY EDMISTON
NAMPA, ID
NPI
1407284698
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: ID LCPC-5607)
Enumeration Date
2013-10-24
Last Update Date
2014-09-25
Business Address
-- JEFFERY EDMISTON M.S., LCPC
4144 E AMITY AVE
NAMPA, ID 83687-8802
Phone number: 208-465-4985
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Mailing Address
-- JEFFERY EDMISTON M.S., LCPC
4144 E AMITY AVE
NAMPA, ID 83687-8802
Phone number: 208-465-4985
Copy
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