Individual
NASEEM KHERICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1904 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 974-5200
Mailing address
PO BOX 4285, POCATELLO, ID 83205-4285
(208) 552-0850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC
IDOL
ID
Enumeration date
10/10/2007
Last updated
07/26/2024
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