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1790853927
JONATHAN ROY MINKOFF
CALDWELL, ID
NPI
1790853927
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: ID LCPC-126)
Enumeration Date
2006-12-04
Last Update Date
2007-07-08
Business Address
JONATHAN ROY MINKOFF LCPC
2020 BLAINE STREET
CALDWELL, ID 83605
Phone number: 208-453-2840
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Mailing Address
JONATHAN ROY MINKOFF LCPC
11648 EVA LANE
CALDWELL, ID 83607-9716
Phone number: 208-453-2840
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