JONATHAN THACKER

PRESTON, ID
NPI1629841952
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LMSW-44232)
Enumeration Date2023-10-30
Last Update Date2023-10-30
Business Address
JONATHAN THACKER
75 S 1ST W
PRESTON, ID 83263-1204
Phone number: 208-852-2370
Mailing Address
JONATHAN THACKER
1327 N 25 E
LAYTON, UT 84041-2977
Phone number: 435-512-6453
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