Individual
STEPHANIE KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
258 N THOMPSON ST, HEMET, CA 92543-4311
(951) 534-9003
Mailing address
258 N THOMPSON ST, HEMET, CA 92543-4311
(951) 534-9003
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-VK5FJX
CA
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/29/2022
Last updated
11/20/2024
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