Individual
KATHERINE WANNETTA KAPUA WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, MS
Contact information
Practice address
1655 W FAIRVIEW AVE STE 209, BOISE, ID 83702-5190
(208) 352-0490
Mailing address
207 E 40TH ST TRLR 6, GARDEN CITY, ID 83714-6386
(208) 352-0490
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
11439605-3902
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11439605-3902
MFT LICENSE NUMBER
UT
01
—
LMFT-8397
MFT LICENSE NUMBER
ID
01
—
MFT.0002602
MFT LICENSE NUMBER
CO
Enumeration date
03/25/2020
Last updated
07/08/2024
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