Individual
MR. DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
845 W CENTER ST, POCATELLO, ID 83204-4205
(208) 589-1568
Mailing address
845 W CENTER ST # C101, POCATELLO, ID 83204-4205
(208) 589-1568
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-10027
ID
104100000X
Social Worker
—
—
Other
Enumeration date
02/14/2012
Last updated
07/11/2025
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