Individual
MRS. KIMBERLY W. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1934 N 26TH W, IDAHO FALLS, ID 83402-5319
(208) 317-5469
Mailing address
1934 N 26TH W, IDAHO FALLS, ID 83402-5319
(208) 317-5469
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4677
ID
Other
Enumeration date
05/15/2012
Last updated
07/20/2020
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