Individual
KIMBERLY CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 HUBBARD WAY STE A, RENO, NV 89502-3780
(775) 829-4472
Mailing address
PO BOX 897, BOISE, ID 83701-0897
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00468-C
NV
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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