Jordan Wixom, LPC, NCC

NPI #1982129177 in Blackfoot, Idaho

Provider Information

NPI Number: 1982129177
Entity Type: Individual
Name: Jordan Wixom, LPC, NCC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC, NCC
Enumeration Date: Aug 8, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 411 RICH LN
City: Blackfoot
State: Idaho
ZIP Code: 83221-3950
Phone: (208) 680-3322

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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