Individual
NIKKI K JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
955 W ALAMEDA RD, POCATELLO, ID 83201-6145
(208) 237-2233
Mailing address
331 N 400 W, BLACKFOOT, ID 83221-5472
(208) 681-8283
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
—
Other
Enumeration date
08/23/2025
Last updated
08/23/2025
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