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MRS. JENNIFER CERVANTES SHUFFIELD LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1770886103

Individual Registrant:
MRS. JENNIFER  CERVANTES SHUFFIELD LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
2606 GRANVILLE ST  MOSCOW, ID 83843-5002 US
Tel: 208-874-2409  Fax: --

Contact information for business:
2606 GRANVILLE ST  MOSCOW, ID 83843-5002 US
Tel: 208-874-2409  Fax: --

Registration Information:
NPI: 1770886103
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
IDLCSW-28718

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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