NPI 1104651462

Melissa Madelyn Wilson

Practitioner Marriage & Family Therapist Rexburg, ID

Practice location

Address: 591 N 2nd E, Rexburg, ID 83440-3566
Phone: (208) 356-6975
Mailing address: 140 Alta North Rd, Alta, WY 83414-4576

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence LMFT-8639 (ID)

Other Marriage & Family Therapist providers in Idaho →

Registry record

NPI: 1104651462
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Sep 2024
Record last updated: 5 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.