Individual
JULIA EVALYNE KIPPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
808 PANCHERI DR, IDAHO FALLS, ID 83402-3344
(208) 552-6900
(208) 552-4973
Mailing address
808 PANCHERI DR, IDAHO FALLS, ID 83402-3344
(208) 552-6900
(208) 552-4973
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-28125
ID
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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