Amy K Jeppesen, L.C.S.W.
Social Worker, Clinical in Boise, ID. Individual provider (NPI-1).
NPI number1467605642
StatusActive
Last updated in NPPESDec 27, 2012
Details
- NPI
- 1467605642
- Entity type
- Individual (NPI-1)
- Name
- Amy K Jeppesen
- Credential
- L.C.S.W.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 31, 2008
- Last updated
- Dec 27, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCSW-27936 | ID | Yes |
| 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 374774-3501 | UT |
Practice location
8950 W Emerald StSuite 178
Boise, ID 83704-4854
Phone 208-376-7083 · Fax 208-321-5069
Mailing address
8950 W Emerald StSuite 178
Boise, ID 83704-4854
Phone 208-376-7083 · Fax 208-321-5069
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