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1346574464
TANNER MITCHELL NIELSEN
IDAHO FALLS, ID
NPI
1346574464
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist Clinical
(Licence: ID PSY-203073)
Enumeration Date
2009-09-22
Last Update Date
2022-11-29
Business Address
DR. TANNER MITCHELL NIELSEN PSYD
2001 S WOODRUFF AVE STE 9
IDAHO FALLS, ID 83404-6371
Phone number: 208-419-3002
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Mailing Address
DR. TANNER MITCHELL NIELSEN PSYD
2001 S WOODRUFF AVE STE 9
IDAHO FALLS, ID 83404-6371
Phone number: 208-419-3002
Copy
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