Individual
JENNIFER ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1873 WALTON AVE, IDAHO FALLS, ID 83401-6842
(986) 800-5350
Mailing address
1873 WALTON AVE, IDAHO FALLS, ID 83401-6842
(986) 800-5350
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/16/2025
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