Individual
JONATHAN ZUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1105 W IRONWOOD DR, COEUR D ALENE, ID 83814-2613
(208) 676-1003
Mailing address
1105 W IRONWOOD DR, COEUR D ALENE, ID 83814-2613
(208) 676-1003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-28419
ID
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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