Healthcare Provider Details

I. General information

NPI: 1932845781
Provider Name (Legal Business Name): ACCESSIBLE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 HILINE RD STE 210
POCATELLO ID
83201-2955
US

IV. Provider business mailing address

1070 HILINE RD STE 210
POCATELLO ID
83201-2955
US

V. Phone/Fax

Practice location:
  • Phone: 208-742-6400
  • Fax: 208-742-6444
Mailing address:
  • Phone: 208-742-6400
  • Fax: 208-742-6444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBRA L AUBREY
Title or Position: OWNER
Credential: PHD
Phone: 208-742-6400