| Doctor Name: | JADE LETOURNEAU |
| NPI Number: | 1053707646 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC-5426 |
| Business Practice Address: | 265 E Chubbuck Rd Chubbuck, ID - 832025055 |
| Business Phone Number: | 2082371711 |
| Business Fax Number: | |
| Mailing Address: | 940 N Garfield Ave, POCATELLO |
| State: | ID |
| Postal Code: | 832042851 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2015 |
| NPI Last Update Date: | 07/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC-5426 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |