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1962111336
JENNIFER RAE WILSON
IDAHO FALLS, ID
NPI
1962111336
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: ID LSW-42274)
Enumeration Date
2022-11-15
Last Update Date
2022-11-15
Business Address
JENNIFER RAE WILSON LSW
1810 W BROADWAY ST
IDAHO FALLS, ID 83402-5072
Phone number: 208-552-7011
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Mailing Address
JENNIFER RAE WILSON LSW
495 W 100 N
BLACKFOOT, ID 83221-5517
Phone number: 208-852-6688
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