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1720171358
BRET V WIXOM
IDAHO FALLS, ID
NPI
1720171358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID 24803)
Enumeration Date
2006-10-02
Last Update Date
2007-07-09
Business Address
-- BRET V WIXOM lcsw
3422 S 15TH E
IDAHO FALLS, ID 83404
Phone number: 208-552-1222
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Mailing Address
-- BRET V WIXOM lcsw
3422 S 15TH E
IDAHO FALLS, ID 83404
Phone number: 208-552-1222
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