Individual
KATHLEEN OLIVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1448 E CENTER ST STE A1, POCATELLO, ID 83201-4132
(208) 220-6891
Mailing address
875 W 150 N, BLACKFOOT, ID 83221-5372
(208) 220-6891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COUI-9713
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
COUI-9713
PROFESSIONAL COUNSELOR LICENSE
ID
Enumeration date
04/22/2026
Last updated
04/22/2026
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