Individual
MRS. KRISTINE E KENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
740 WARM SPRINGS AVE, BOISE, ID 83712-6420
(208) 343-7797
(208) 343-0064
Mailing address
817 E HIGHLAND VIEW DR, BOISE, ID 83702-1928
(208) 371-1959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-902
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015713
REGENCE BLUE SHIELD
ID
01
—
L9123
BLUE CROSS OF IDAHO
ID
Enumeration date
03/15/2007
Last updated
07/08/2007
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