Individual
MR. JONATHAN WELDON GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCP
Contact information
Practice address
6010 W OVERLAND RD, BOISE, ID 83709-3013
(208) 377-5720
Mailing address
2860 E VICTORY RD, MERIDIAN, ID 83642-7051
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCP3
ID
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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