BRIAN WIXOM

BOISE, ID
NPI1619331535
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: ID  LSW-2466)
Enumeration Date2016-04-06
Last Update Date2016-04-06
Business Address
-- BRIAN WIXOM LSW
1720 N WESTGATE DR STE A-1
BOISE, ID 83704-7164
Phone number: 208-334-0734
Mailing Address
-- BRIAN WIXOM LSW
1720 N WESTGATE DR STE A-1
BOISE, ID 83704-7164
Phone number: 208-334-0734
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