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Individual

MAXWELL REAS ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1820 E 17TH ST STE 355, IDAHO FALLS, ID 83404-6453
(208) 497-0685
(208) 497-0239
Mailing address
965 SYRINGA DR, IDAHO FALLS, ID 83401-4019

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/12/2026
Last updated
01/12/2026
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