Individual
JON VERDUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2607 KERR STREET, BOISE, ID 83701-0357
(208) 283-1605
Mailing address
PO BOX 357, BOISE, ID 83701-0357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/27/2010
Last updated
04/11/2012
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