Individual
MRS. KATHRYN CANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
713 S LEADVILLE, SUITE 3, SUN VALLEY, ID 83353
(208) 806-1194
Mailing address
PO BOX 6614, KETCHUM, ID 83340-6614
(208) 806-1194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8243
ID
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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