Jacob Pannell

NPI #1396519880 in Lewiston, Idaho

Provider Information

NPI Number: 1396519880
Entity Type: Individual
Name: Jacob Pannell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Nov 14, 2023
Last Updated: Nov 14, 2023

Practice Location

Address: 1630 23RD AVE BLDG 2
City: Lewiston
State: Idaho
ZIP Code: 83501-6350
Phone: (208) 746-7784

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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