Individual
MS. MELISSA ANN MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
570 LYN AVE, IDAHO FALLS, ID 83401-3830
(208) 520-2574
Mailing address
570 LYN AVE, IDAHO FALLS, ID 83401-3830
(208) 520-2574
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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