Lilly, Jerry Duane
Lilly, Jerry Duane is an sole proprietor health care provider with primary practice located at 172 S Academy Ave Ste 160 , Eagle ID 83616-6564. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Lilly, Jerry Duane can be contacted via phone (208) 315-4855.Contact Information
Primary practice address
172 S Academy Ave Ste 160
Eagle ID 83616-6564
Phone: (208) 315-4855
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LCPC-6990 | Idaho |
Profile Details
| NPI number | 1124390786 |
|---|---|
| LBN Legal business name | Lilly, Jerry Duane |
| Credentials | ED.S |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2012 |
| Last updated | Dec 6th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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