Individual
JESSICA L WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2420 E 25TH ST STE A, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 557-7494
Mailing address
2420 E 25TH ST STE A, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 557-7494
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC- 3725
ID
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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