| Doctor Name: | JENNIFER ANN LA JEUNESSE |
| NPI Number: | 1013106434 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LCSW-28431 |
| Business Practice Address: | 520 S Eagle Rd Ste 2106 Meridian, ID - 836426363 |
| Business Phone Number: | 2087065775 |
| Business Fax Number: | 2087065777 |
| Mailing Address: | 5648 N Parchment Ave, BOISE |
| State: | ID |
| Postal Code: | 837131270 |
| Phone Number: | 2086295119 |
| Fax Number: | 2087065777 |
| NPI Enumeration Date: | 10/22/2007 |
| NPI Last Update Date: | 10/22/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW-28431 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |