Individual
CASSI KIMBERLY FACKRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NBC-HWC
Contact information
Practice address
257 S RIGGS SPRING AVE, MERIDIAN, ID 83642-5697
(208) 246-9472
Mailing address
257 S RIGGS SPRING AVE, MERIDIAN, ID 83642-5697
(208) 246-9472
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
A-3962199
ID
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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