JUAN LUCERO

POCATELLO, ID
NPI1821463704
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-38062)
Enumeration Date2015-12-03
Last Update Date2021-01-07
Business Address
JUAN LUCERO LCSW-38062
412 W CENTER ST STE 300
POCATELLO, ID 83204-3238
Phone number: 208-406-9323
Mailing Address
JUAN LUCERO LCSW-38062
957 HIGHLAND BLVD
POCATELLO, ID 83204-4730
Phone number: 208-406-9323