Individual
RACHEL M KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1337 E 17TH ST, IDAHO FALLS, ID 83404
(208) 556-3616
(208) 202-2769
Mailing address
1337 E 17TH ST STE B, IDAHO FALLS, ID 83404-6235
(208) 556-3616
(208) 202-2769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-32901
ID
1041C0700X
Clinical Social Worker
Primary
LCSW35479
ID
Other
Enumeration date
07/15/2013
Last updated
07/06/2023
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