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1518978949
CHARLES MICHAEL JEWELL
BOISE, ID
NPI
1518978949
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LPC-2785)
Enumeration Date
2006-08-10
Last Update Date
2007-07-08
Business Address
Mr. CHARLES MICHAEL JEWELL LPC
500 W FORT ST BLDG 23
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
Mr. CHARLES MICHAEL JEWELL LPC
PO BOX 1364
MOUNTAIN HOME, ID 83647-1364
Phone number:
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