| Jackie Nelson, Pllc | |
|
202 N 9th St Ste 401c Boise ID 83702-5770 | |
| (208) 639-9192 | |
| Not Available |
| Full Name | Jackie Nelson, Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 202 N 9th St Ste 401c, Boise, Idaho |
| Authorized Official Name and Position | Jacquelyn Nelson (OWNER AND COUNSELOR) |
| Authorized Official Contact | 4803165462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackie Nelson, Pllc 4621 W Kendall St Boise ID 83706-2222 Ph: (480) 316-5462 | Jackie Nelson, Pllc 202 N 9th St Ste 401c Boise ID 83702-5770 Ph: (208) 639-9192 |
| NPI Number | 1033740865 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 01/30/2020 |
| Certification Date | 01/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033740865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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