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General NPI Number Information
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NPI Number | 1659437200
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Entity Type | Individual
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Provider Name | JACALYN RAMSEY LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 2995 N COLE RD SUITE 200 B
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City | BOISE
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State | ID
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Zip | 83704-5964
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Country | US
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Telephone | 208-376-8222
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Fax | 208-376-5222
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Provider Business Mailing Address
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Address Line | 8435 W CASCADE LN
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City | BOISE
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State | ID
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Zip | 83704-8312
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Country | US
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Telephone | 208-376-8222
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Fax | 208-376-5222
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC-3961
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License Number State | ID
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