Zachary Wixom, LMSW

NPI #1023507977 in Idaho Falls, Idaho

Provider Information

NPI Number: 1023507977
Entity Type: Individual
Name: Zachary Wixom, LMSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LMSW
Enumeration Date: May 7, 2018
Last Updated: May 7, 2018

Practice Location

Address: 150 SHOUP AVE
City: Idaho Falls
State: Idaho
ZIP Code: 83402-3657
Phone: (208) 528-5712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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