Individual
PAMELA CHRISTINE BUXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2635 CHANNING WAY, SUITE B, IDAHO FALLS, ID 83404-7518
(208) 552-0490
(208) 552-2518
Mailing address
PO BOX 2651, IDAHO FALLS, ID 83403-2651
(208) 525-2090
(208) 523-8978
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-5192
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235401522
—
ID
Enumeration date
02/19/2013
Last updated
11/04/2014
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