| Jill J. Sprague, Ma, Lcpc | |
|
829b S Washington Ave Emmett ID 83617-3528 | |
| (208) 365-3141 | |
| (208) 398-8311 |
| Full Name | Jill J. Sprague, Ma, Lcpc |
|---|---|
| Speciality | Counselor |
| Location | 829b S Washington Ave, Emmett, Idaho |
| Authorized Official Name and Position | Jill J Sprague (OWNER) |
| Authorized Official Contact | 2083653141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill J. Sprague, Ma, Lcpc 829b S Washington Ave Emmett ID 83617-3528 Ph: (208) 365-3141 | Jill J. Sprague, Ma, Lcpc 829b S Washington Ave Emmett ID 83617-3528 Ph: (208) 365-3141 |
| NPI Number | 1407329469 |
|---|---|
| Provider Enumeration Date | 01/02/2019 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407329469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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