NPI 1891353199

Jonathan Marcel Moses

Practitioner Clinical Social Worker Rigby, ID

Practice location

Address: 295 N 3855 E, Rigby, ID 83442-5124
Phone: (208) 745-5205
Mailing address: 2275 W Broadway St, Idaho Falls, ID 83402-2902

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence LCSW-42172 (ID)

Other Social Worker providers in Idaho →

Registry record

NPI: 1891353199
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 May 2019
Record last updated: 10 May 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.