Jan Fisher Clark, LPC Valid NPI
Individual provider · Professional Counselor · Chubbuck, ID
- NPI
- 1548927379
- Type
- Individual (Type 1)
- Primary specialty
- Professional Counselor (Counselor)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101YP2500X
- License number
- LPC-8452 (ID)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2021-11-29
- Last updated
- 2021-11-29
Practice location
265 E Chubbuck Rd
Chubbuck, ID 83202-5055
(208) 237-1711