Individual
ELEXA WASDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(888) 392-8642
Mailing address
289 COTTAGE PL, IDAHO FALLS, ID 83402-4213
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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