Individual
JONATHAN RAY GILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
8050 W NORTHVIEW ST, BOISE, ID 83704-7126
(208) 327-0504
Mailing address
8050 W NORTHVIEW ST, BOISE, ID 83704-7126
(208) 327-0504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
42310
ID
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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