NICHOLE CHAUNTELLE WILSON

IDAHO FALLS, ID
NPI1740730811
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy222Q00000X Developmental Therapist
Enumeration Date2016-10-12
Last Update Date2016-10-12
Business Address
-- NICHOLE CHAUNTELLE WILSON
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number: 208-359-4778
Mailing Address
-- NICHOLE CHAUNTELLE WILSON
150 SHOUP AVE
IDAHO FALLS, ID 83402-3657
Phone number: 208-359-4778
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