Jefferson H Kraczek LCSW

NPI 1093087033 - Social Worker - 1041C0700X

NPI Details
NPI 1093087033
Gender Male
Enumeration Date 02/07/2012
Last Updated 02/07/2012
Entity Type Individual
Active Over 5 years ago
Practice Location
1970 E 17TH ST STE 202
IDAHO FALLS ID, 83404-8048, US
Phone (208) 523-5319
Fax (208) 523-5627
Business Location
1970 E 17TH ST STE 202
IDAHO FALLS ID, 83404-8048, US
Phone (208) 523-5319
Fax (208) 523-5627
Toxanomy
Taxonomy Code 1041C0700X
License State Idaho
License Number LCSW-27821
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According to our database, Mr. Jefferson H Kraczek LCSW NPI is 1093087033, taxonomy code is 1041C0700X and license number is LCSW-27821, license state is located at Idaho. Jefferson H Kraczek LCSW physically located at 1970 E 17th St Ste 202, Idaho Falls ID, 83404-8048. NPI Number Jefferson H Kraczek LCSW has the Individual type.

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1093087033 NPI number is provided on an as is basis without warranty of any kind. 1093087033 is maintained by the National Plan & Provider Enumeration System. The contents of Jefferson H Kraczek LCSW are for informational purposes only.