Individual
JEREMY THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
456 WEST ORCHARD AVE., APT D305, NAMPA, ID 83651
(260) 312-3288
Mailing address
456 W ORCHARD AVE, APARTMENT #D 305, NAMPA, ID 83651-1992
(260) 312-3288
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/29/2015
Last updated
04/29/2015
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