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Individual

MRS. KRISTI JEAN FOWLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
140 RIVER VISTA PL, TWIN FALLS, ID 83301-3056
(208) 732-0405
(208) 732-0407
Mailing address
1166 EASTRIDGE CT, TWIN FALLS, ID 83301-7964
(208) 731-0558

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-3585
ID
106H00000X
Marriage & Family Therapist
MFC 37523
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000007224
UNITED BEHAVIORAL HEALTH
ID
01
000010155785
REGENCE BLUE SHIELD
ID
01
11653580
CAQH
ID
01
2349596
CIGNA
ID
01
Q7411
BLUE CROSS OF IDAHO
ID
Enumeration date
03/14/2007
Last updated
02/11/2010
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