Individual
MR. JORDAN LOOZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4948 W KOOTENAI ST, SUITE 207, BOISE, ID 83705-2080
(208) 371-4548
Mailing address
4948 W KOOTENAI ST, SUITE 207, BOISE, ID 83705-2080
(208) 371-4548
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5280
ID
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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