Individual
JENNIE R NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 E 16TH ST, IDAHO FALLS, ID 83404-5919
(208) 523-6727
Mailing address
1231 S UNIVERSITY AVE, BLACKFOOT, ID 83221-3556
(907) 297-9259
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
101YP2500X
Professional Counselor
Primary
LPC-10394
ID
Other
Enumeration date
03/26/2024
Last updated
02/26/2026
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