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Individual

JOEL BOCANEGRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
357 W CENTER ST STE 3, POCATELLO, ID 83204-3236
(208) 244-0081
Mailing address
5740 ARROWHEAD DR, POCATELLO, ID 83204-4659
(502) 689-3428

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-203077
ID

Other

Enumeration date
10/17/2018
Last updated
01/27/2024
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