DR. Jack D Newsome, PH.D LCPC

NPI #1124169354 in Pocatello, Idaho

Provider Information

NPI Number: 1124169354
Entity Type: Individual
Name: DR. Jack D Newsome, PH.D LCPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: PH.D LCPC
Enumeration Date: Feb 9, 2007
Last Updated: Jul 9, 2007

Practice Location

Address: 732 WASHINGTON AVE
City: Pocatello
State: Idaho
ZIP Code: 83201-3748
Phone: (208) 478-9822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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