Individual
JARICA WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1970 E 17TH ST STE 202, IDAHO FALLS, ID 83404-8048
(208) 523-5319
Mailing address
3795 E. BLUESTONE, IDAHO FALLS, ID 83401
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
N-36525
ID
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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