Individual
MRS. JANIS GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
500 W FORT ST, BOISE VAMC, BOISE, ID 83702-4501
(208) 422-1360
Mailing address
3493 E FLORENCE DR, MERIDIAN, ID 83642-6049
(208) 888-5044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW- 26245
ID
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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