Jessica Dee Bastian LMSW

NPI 1003185745 - Social Worker - 104100000X

NPI Details
NPI 1003185745
Gender Female
Enumeration Date 12/27/2011
Last Updated 12/27/2011
Entity Type Individual
Active Over 4 years ago
Practice Location
421 N 19TH ST
BOISE ID, 83702-3948, US
Phone (208) 863-8210
Business Location
BOISE ID, 83709-5207, US
Phone (208) 863-8210
Taxonomy Code 104100000X
License State Idaho
License Number LMSW-30582
Remove 1003185745 NPI Number

According to our database, Ms. Jessica Dee Bastian LMSW NPI is 1003185745, taxonomy code is 104100000X and license number is LMSW-30582, license state is located at Idaho. Jessica Dee Bastian LMSW physically located at 421 N 19th St, Boise ID, 83702-3948. NPI Number Jessica Dee Bastian LMSW has the Individual type.

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1003185745 NPI number is provided on an as is basis without warranty of any kind. 1003185745 is maintained by the National Plan & Provider Enumeration System. The contents of Jessica Dee Bastian LMSW are for informational purposes only.