Individual
TALON GERVIS MANSFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 S 1ST E, REXBURG, ID 83440-1902
(208) 656-4484
Mailing address
148 W 4TH N, SAINT ANTHONY, ID 83445-1439
(801) 400-2977
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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