Individual
KRISTI SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
550 W SUNNYSIDE RD STE 1, IDAHO FALLS, ID 83402-4642
(208) 529-5777
Mailing address
1508 N MARCHESA LN, IDAHO FALLS, ID 83402-1220
(208) 243-1249
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8331553
ID
101YP2500X
Professional Counselor
Primary
9542
ID
Other
Enumeration date
06/29/2023
Last updated
02/18/2026
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