Wilson-Lucero, Jessica Michelle

Wilson-Lucero, Jessica Michelle is an sole proprietor health care provider with primary practice located at 395 1/2 Willard Ave , Pocatello ID 83201-4524. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Wilson-Lucero, Jessica Michelle can be contacted via phone (208) 240-4063.

Contact Information

Primary practice address
395 1/2 Willard Ave Pocatello ID 83201-4524
Phone: (208) 240-4063
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X Idaho

Profile Details

NPI number 1023622321
LBN Legal business name Wilson-Lucero, Jessica Michelle
Credentials ED.S, NCSP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 3rd, 2020
Last updated Sep 3rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers