Individual provider · Type 1 NPI

Kory David Wilson, CMHC-7172909-6004

Professional Counselor · Rexburg, ID

NPI number 1467675975 Active

Practice location

218 Dividend Dr Ste 3
Rexburg, ID 83440-3510

Call (208) 359-9683 Map

Fax (208) 359-9683

Mailing address

490 Pioneer Rd Apt 8301
Rexburg, ID 83440-5285

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLPC-3463 (ID)

Professional Counselor: Definition to come...

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About NPI 1467675975

Kory David Wilson, CMHC-7172909-6004's National Provider Identifier is 1467675975, issued on Apr 11, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Rexburg, ID. The record was last updated on Jun 10, 2026.