Organization
K2 FMILY PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE WACHOLZ (CLINICAL SUPERVISOR)
(208) 699-1704
Entity
Organization
Contact information
Practice address
5723 E DODD RD, HAYDEN LAKE, ID 83835-9376
(208) 699-1704
Mailing address
5723 E DODD RD, HAYDEN LAKE, ID 83835-9376
(208) 699-1704
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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