Individual
VALINDA L MIKESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1301 E 17TH ST, IDAHO FALLS, ID 83404-6273
(208) 538-3122
Mailing address
391 FALLS DR, IDAHO FALLS, ID 83401-3207
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-7661
ID
Other
Enumeration date
05/06/2020
Last updated
05/08/2020
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