Jessica Michelle Wilson-Lucero
School Psychologist
395 1/2 Willard Ave
Pocatello
, Idaho 83201-4524
Jessica Michelle Wilson-Lucero
School Psychologist
395 1/2 Willard Ave
Pocatello
, Idaho 83201-4524
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About
Features
Specialties
- School Psychologist
Languages spoken
- English
Location
First Address
- Jessica Michelle Wilson-Lucero
- 395 1/2 Willard Ave
- Pocatello, ID
- Zip : 83201-4524
- Phone :
Second Address
- Jessica Michelle Wilson-Lucero
- 395 1/2 Willard Ave
- Pocatello, ID
- Zip : 83201-4524
- Phone : (208) 240-4063
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TS0200X | School Psychologist | ID |
National Provider Identifier
| NPI | 1023622321 |
|---|---|
| Provider Name | Jessica Michelle Wilson-Lucero |
| First Address | Pocatello, ID 83201-4524 |
| Second Address | Pocatello, ID 83201-4524 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/09/2020 |
| Last Update Date | 03/09/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.