Doctor Name: | MS. JANELL CLEMENT |
NPI Number: | 1083026272 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCSW-33815 |
Business Practice Address: | 218 Dividend Dr Rexburg, ID - 83440 |
Business Phone Number: | 2083599683 |
Business Fax Number: | |
Mailing Address: | 12 Jaxon Dr, SUGAR CITY |
State: | ID |
Postal Code: | 83448 |
Phone Number: | 2008390872 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2014 |
NPI Last Update Date: | 05/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCSW-33815 |
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 |