Individual
MRS. ELDA JANNAE WALDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
589 TYSON AVE, IDAHO FALLS, ID 83401-3315
(352) 425-5896
Mailing address
589 TYSON AVE, IDAHO FALLS, ID 83401-3315
(352) 425-5896
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-174
ID
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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