SearchIdaho103TS0200X

Jessica Wilson-Lucero, ED.S, NCSP

NPI 1023622321 · on the registry since 2020 · sole proprietor

Practice

Address
395 1/2 Willard Ave
Pocatello, ID 83201
Phone
(208) 240-4063

Registry record

Primary taxonomy
103TS0200X
103TS0200X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-09-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho