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Organization

FULFILLMENT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENDRA JEAN NIELSON LPC (COUNSELOR)
(208) 757-0067
Entity
Organization

Contact information

Practice address
14331 CREGO ST, CALDWELL, ID 83607-4815
(208) 290-0075
Mailing address
14331 CREGO ST, CALDWELL, ID 83607-4815
(208) 284-7233

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/11/2023
Last updated
01/11/2023
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