Individual
WYATT SEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1908 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 315-9097
Mailing address
1908 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
Other
Enumeration date
05/23/2026
Last updated
05/23/2026
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