Jonathan Thacker, | |
75 S 1st W, Preston, ID 83263-1204 | |
(208) 852-2370 | |
Not Available |
Full Name | Jonathan Thacker |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 75 S 1st W, Preston, Idaho |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629841952 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LMSW-44232 (Idaho) | Primary |
Mailing Address | Practice Location Address |
---|---|
Jonathan Thacker, 1327 N 25 E, Layton, UT 84041-2977 Ph: (435) 512-6453 | Jonathan Thacker, 75 S 1st W, Preston, ID 83263-1204 Ph: (208) 852-2370 |
Trent Beutler Alder, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 44 N 100 E, Preston, ID 83263 Phone: 208-852-4107 | |
Mrs. Alyssa Dyer, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 75 S 1st W, Preston, ID 83263 Phone: 208-852-2370 |