Individual
KIMBERLY KAYE NEALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LCPC, ACADC
Contact information
Practice address
404 S EAGLE RD, SUITE C, EAGLE, ID 83616-6069
(208) 989-1957
Mailing address
1903 W BLOSSOM AVE, NAMPA, ID 83651-8323
(208) 989-1957
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
ID
101YM0800X
Mental Health Counselor
Primary
4163
ID
101YP2500X
Professional Counselor
LPC-3144
ID
Other
Enumeration date
03/17/2008
Last updated
11/14/2008
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