Individual
JENNIFER MIESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
231 N 6TH AVE, POCATELLO, ID 83201-6211
(208) 254-1694
(208) 904-4458
Mailing address
231 N 6TH AVE, POCATELLO, ID 83201-6211
(208) 254-1694
(208) 904-4458
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-202631
ID
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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