Individual
HOLLY MARIAH GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026
Mailing address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6147
(208) 542-1026
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7261576
ID
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
ID
Enumeration date
02/23/2021
Last updated
08/27/2024
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