Individual
KATHERINE ANN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, SIT
Contact information
Practice address
540 3RD ST, IDAHO FALLS, ID 83404
(208) 524-5607
(208) 524-0636
Mailing address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
07/07/2017
Last updated
11/18/2024
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