Individual provider · Type 1 NPI

Jennifer Wade, COUNSELOR INTERN

Professional Counselor · Moscow, ID

NPI number 1356053409 Active

Practice location

317 W 6th St Ste 208
Moscow, ID 83843-2387

Mailing address

421 E 6th St Apt 3
Moscow, ID 83843-2954

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC-10126 (ID)

Professional Counselor: Definition to come...

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About NPI 1356053409

Jennifer Wade, COUNSELOR INTERN's National Provider Identifier is 1356053409, issued on Dec 20, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Moscow, ID. The record was last updated on Oct 19, 2026.