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Individual

MR. JOHN GLISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.C.P.C.

Contact information

Practice address
849 E FAIRVIEW AVE, MERIDIAN, ID 83642-1806
(208) 866-0045
Mailing address
849 E FAIRVIEW AVE, MERIDIAN, ID 83642-1806
(208) 866-0045

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC - 4996
ID

Other

Enumeration date
05/22/2013
Last updated
02/07/2016
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