Individual
DALLIN JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2991 JACKIE CT, IDAHO FALLS, ID 83402-5571
(802) 918-3912
Mailing address
2991 JACKIE CT, IDAHO FALLS, ID 83402-5571
(802) 918-3912
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/07/2017
Last updated
07/13/2023
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