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1023507977
ZACHARY WIXOM
IDAHO FALLS, ID
NPI
1023507977
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-05-07
Last Update Date
2018-05-07
Business Address
ZACHARY WIXOM LMSW
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number: 208-528-5712
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Mailing Address
ZACHARY WIXOM LMSW
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number:
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