person
Jordan Wixom, LPC,NCC
Professional Counselor in Blackfoot, Idaho
NPI 1982129177

Jordan Wixom is a Professional Counselor based in Blackfoot, ID and is specialized in Professional. Jordan Wixom practices in Blackfoot, ID and has the professional credentials of LPC,NCC. The NPI Number for Jordan Wixom is 1982129177 and holds a License No. LPC-6568 (Idaho).

The current practice location address for Jordan Wixom is 411 Rich Ln, Blackfoot, ID and can be reached out via phone at 208-680-3322. You can also correspond with Jordan Wixom through the mailing address at 411 RICH LN, BLACKFOOT, ID - 83221-3950 (mailing address contact number: 208-680-3322).

Location: 411 Rich Ln, Blackfoot, ID, 83221-3950
person
Provider Profile Details
NPI Number
1982129177
Provider Name
Jordan Wixom
Credential
LPC,NCC
Provider Entity Type
Individual
Gender
Female
Address
411 Rich Ln, Blackfoot, ID, 83221-3950
Phone Number
208-680-3322
Fax Number
Provider Enumeration Date
08/08/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
411 Rich Ln
City
State
Zip
83221-3950
Phone Number
208-680-3322
Fax Number
person
Provider Business Mailing Address Details
Address
411 Rich Ln
City
State
Zip
83221-3950
Phone Number
208-680-3322
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LPC-6568 (Idaho)
Definition
Definition to come...
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