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General NPI Number Information
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NPI Number | 1013177567
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Entity Type | Individual
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Provider Name | JENA FARID LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 2101 N LAKEWOOD DR STE 222
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2473
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Country | US
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Telephone | 208-274-3320
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 N LAKEWOOD DR STE 222
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2473
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Country | US
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Telephone | 208-274-3320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT125510
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-8584
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License Number State | ID
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