| Jennifer Miesch Phd | |
|
231 N 6th Ave Pocatello ID 83201-6211 | |
| (208) 254-1694 | |
| (208) 904-4458 |
| Full Name | Jennifer Miesch Phd |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 231 N 6th Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Jennifer Miesch (OWNER) |
| Authorized Official Contact | 2082541694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Miesch Phd 231 N 6th Ave Pocatello ID 83201-6211 Ph: (208) 254-1694 | Jennifer Miesch Phd 231 N 6th Ave Pocatello ID 83201-6211 Ph: (208) 254-1694 |
| NPI Number | 1164145926 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 06/28/2023 |
| Certification Date | 06/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164145926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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