Individual
SHANON KANEKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 W CENTER ST STE 350, POCATELLO, ID 83204-3238
(208) 261-2131
Mailing address
469 RAVEN WAY APT B, CHUBBUCK, ID 83202-1955
(208) 242-8099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/03/2014
Last updated
03/19/2026
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