Individual
KALLEY WARD MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 W NORCREST DR, BOISE, ID 83705-4346
(208) 371-9474
Mailing address
2401 W NORCREST DR, BOISE, ID 83705-4346
(208) 371-9474
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/05/2020
Last updated
01/05/2020
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