Individual
KAYLA J GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
845 W CENTER ST, POCATELLO, ID 83204-4205
(208) 729-6041
Mailing address
921 S 8TH AVE BOX 8226, POCATELLO, ID 83209-0001
(832) 585-7957
(208) 992-0241
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8331384
ID
Other
Enumeration date
08/02/2023
Last updated
10/01/2024
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