Organization
FULL SPECTRUM THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENN GALLUP PH.D. (PSYCHOLOGIST)
(208) 406-2492
Entity
Organization
Contact information
Practice address
805 N ARTHUR AVE, POCATELLO, ID 83204-2803
(208) 274-5925
Mailing address
805 N ARTHUR AVE, POCATELLO, ID 83204-2803
(208) 274-5925
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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