Individual
KENISHA GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
522 LOMAX ST, IDAHO FALLS, ID 83401
(208) 522-6925
(208) 522-6925
Mailing address
522 LOMAX ST, IDAHO FALLS, ID 83401
(208) 522-6925
(208) 522-6925
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000
ID
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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