Individual
GLENDA K THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2235 E 25TH ST, SUITE 290, IDAHO FALLS, ID 83404-7519
(208) 552-0490
(208) 552-2518
Mailing address
2235 E 25TH ST, SUITE 290, IDAHO FALLS, ID 83404-7519
(208) 552-0490
(208) 552-2518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW-21529
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW30186
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806472900
—
ID
Enumeration date
04/13/2010
Last updated
09/04/2024
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