Wixom, Jordan

Wixom, Jordan is an sole proprietor health care provider with primary practice located at 411 Rich Ln , Blackfoot ID 83221-3950. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wixom, Jordan can be contacted via phone (208) 680-3322.

Contact Information

Primary practice address
411 Rich Ln Blackfoot ID 83221-3950
Phone: (208) 680-3322
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-6568 Idaho

Profile Details

NPI number 1982129177
LBN Legal business name Wixom, Jordan
Credentials LPC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 8th, 2017
Last updated Jul 21st, 2022 - about 3 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.

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