Jessica Michelle Wilson-Lucero, ED.S, NCSP

NPI #1023622321 in Pocatello, Idaho

Provider Information

NPI Number: 1023622321
Entity Type: Individual
Name: Jessica Michelle Wilson-Lucero, ED.S, NCSP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - School
Credential: ED.S, NCSP
Enumeration Date: Sep 3, 2020
Last Updated: Sep 3, 2020

Practice Location

Address: 395 1/2 WILLARD AVE
City: Pocatello
State: Idaho
ZIP Code: 83201-4524
Phone: (208) 240-4063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - School — School	103TS0200X	Primary

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