person
Mr. Kory David Wilson, LPC-3463
Professional Counselor in Rexburg, Idaho
NPI 1467675975

Kory David Wilson is a Professional Counselor based in Rexburg, ID and is specialized in Professional. Kory David Wilson practices in Rexburg, ID and has the professional credentials of LPC-3463. The NPI Number for Kory David Wilson is 1467675975 and holds a License No. LPC-3463 (Idaho).

The current practice location address for Kory David Wilson is 218 Dividend Dr Ste 3, Rexburg, ID and can be reached out via phone at 208-359-9683 and via fax at 208-359-9683. You can also correspond with Kory David Wilson through the mailing address at 490 PIONEER RD APT 8301, REXBURG, ID - 83440-5285 (mailing address contact number: 208-521-8173).

Location: 218 Dividend Dr Ste 3, Rexburg, ID, 83440-5285
person
Provider Profile Details
NPI Number
1467675975
Provider Name
Kory David Wilson
Credential
LPC-3463
Provider Entity Type
Individual
Gender
Male
Address
218 Dividend Dr Ste 3, Rexburg, ID, 83440-5285
Phone Number
208-359-9683
Fax Number
208-359-9683
Provider Enumeration Date
04/11/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
218 Dividend Dr Ste 3
City
State
Zip
83440-3510
Phone Number
208-359-9683
Fax Number
208-359-9683
person
Provider Business Mailing Address Details
Address
490 Pioneer Rd Apt 8301
City
State
Zip
83440-5285
Phone Number
208-521-8173
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LPC-3463 (Idaho)
Definition
Definition to come...
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