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General NPI Number Information
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NPI Number | 1699417220
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Entity Type | Organization
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Legal Business Name | JAMIESON CONSULTING
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 106 E PARK ST STE 218
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City | MCCALL
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State | ID
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Zip | 83638-5069
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Country | US
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Telephone | 208-630-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 106 E PARK ST STE 218
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City | MCCALL
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State | ID
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Zip | 83638-5069
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Country | US
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Telephone | 208-630-4200
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | TRACI JAMIESON
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Credential | LPC
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Telephone | 208-630-4200
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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 |
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License Number State |
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