Individual
JESSICA LYNNE DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2375 E SUNNYSIDE RD STE C, IDAHO FALLS, ID 83404-8281
(208) 529-5777
(208) 529-5778
Mailing address
2375 E SUNNYSIDE RD STE C, IDAHO FALLS, ID 83404-8281
(208) 529-5777
(208) 529-5778
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-4767
ID
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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