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1518708171
VICTOR KIERNAN THOMAS
CHUBBUCK, ID
NPI
1518708171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID 10431)
Enumeration Date
2024-06-05
Last Update Date
2024-06-05
Business Address
VICTOR KIERNAN THOMAS
4650 HAWTHORNE RD STE 3B
CHUBBUCK, ID 83202-2376
Phone number: 208-648-4167
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Mailing Address
VICTOR KIERNAN THOMAS
4650 HAWTHORNE RD
CHUBBUCK, ID 83202-2376
Phone number: 208-648-4167
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