AMANDA JACK
Individual Provider (NPI-1)
Active
Psychologist
Provider Information
- NPI Number
1386371235- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2463 E GALA ST, MERIDIAN, ID, 836425209
- Phone
- (208) 955-7333
Specialties & Taxonomies
Counselor, Mental Health
Student in an Organized Health Care Education/Training Program
Psychologist
Primary