| Jessica Bullwinkle, Ma, Lmft | |
|
2618 East Snocreek Eagle ID 83616 | |
| (208) 231-7308 | |
| Not Available |
| Full Name | Jessica Bullwinkle, Ma, Lmft |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2618 East Snocreek, Eagle, Idaho |
| Authorized Official Name and Position | Jessica Angelic Bullwinkle (OWNER) |
| Authorized Official Contact | 2082317308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Bullwinkle, Ma, Lmft 2618 E Snocreek Dr Eagle ID 83616-5816 Ph: (208) 231-7308 | Jessica Bullwinkle, Ma, Lmft 2618 East Snocreek Eagle ID 83616 Ph: (208) 231-7308 |
| NPI Number | 1629613823 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 08/24/2021 |
| Certification Date | 08/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629613823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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