Individual
BRYNN NOEL POTERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1262 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 346-0688
Mailing address
1262 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 346-0688
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
OH
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
8911330
ID
Other
Enumeration date
06/23/2022
Last updated
04/08/2026
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