Organization
JENNIFER MIESCH PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MIESCH PHD (OWNER)
(208) 254-1694
Entity
Organization
Contact information
Practice address
231 N 6TH AVE, POCATELLO, ID 83201-6211
(208) 254-1694
(208) 904-4458
Mailing address
231 N 6TH AVE, POCATELLO, ID 83201-6211
(208) 254-1694
(208) 904-4458
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/26/2022
Last updated
06/28/2023
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