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1982129177
JORDAN WIXOM
BLACKFOOT, ID
NPI
1982129177
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC-6568)
Enumeration Date
2017-08-08
Last Update Date
2022-07-21
Business Address
JORDAN WIXOM LPC, NCC
411 RICH LN
BLACKFOOT, ID 83221-3950
Phone number: 208-680-3322
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Mailing Address
JORDAN WIXOM LPC, NCC
411 RICH LN
BLACKFOOT, ID 83221-3950
Phone number: 208-680-3322
Copy
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