BRET V WIXOM

IDAHO FALLS, ID
NPI1720171358
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  24803)
Enumeration Date2006-10-02
Last Update Date2007-07-09
Business Address
-- BRET V WIXOM lcsw
3422 S 15TH E
IDAHO FALLS, ID 83404
Phone number: 208-552-1222
Mailing Address
-- BRET V WIXOM lcsw
3422 S 15TH E
IDAHO FALLS, ID 83404
Phone number: 208-552-1222
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