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General NPI Number Information
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NPI Number | 1952129231
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Entity Type | Individual
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Provider Name | JILL ASHLEY SIMPSON MS,CRC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 6126 W STATE ST STE 402
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City | BOISE
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State | ID
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Zip | 83703-2741
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Country | US
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Telephone | 208-479-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 452 E THURMAN MILL ST
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City | GARDEN CITY
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State | ID
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Zip | 83714-6565
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Country | US
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Telephone | 208-577-8701
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8561779
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License Number State | ID
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