Individual
TAKOMA LINDSAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3940 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 252-5545
Mailing address
2666 LAVENDER DR, IDAHO FALLS, ID 83401-6256
(208) 252-5545
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
12439475-3904
UT
106H00000X
Marriage & Family Therapist
Primary
2871447
ID
Other
Enumeration date
02/13/2024
Last updated
04/14/2025
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