Jacob Pannell
Jacob Pannell is an Addiction (Substance Use Disorder) Counselor in Lewiston, Idaho. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
1630 23rd Ave Bldg 2Lewiston, ID 83501-6350
Phone: (208) 746-7784
Fax: (208) 798-8652
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X |
|---|
Record details
| NPI number | 1396519880 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | November 14, 2023 |
| Last updated in NPPES | November 14, 2023 |
| Certification date | November 14, 2023 |
| Mailing address | Po Box 812, Lewiston, ID 83501-0812 |
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