Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nichole Chauntelle Wilson

Individual provider Developmental Therapist · NPI 1740730811

Nichole Chauntelle Wilson is a Developmental Therapist in Idaho Falls, Idaho. Practices as a sole proprietor. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

150 Shoup Ave
Idaho Falls, ID 83402-3657
Phone: (208) 359-4778
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Therapist (primary) Taxonomy 222Q00000X

Record details

NPI number1740730811
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 12, 2016
Last updated in NPPESOctober 12, 2016

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