Individual
KYLEE A MCMANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 S BRIDGEWAY PL STE 280, EAGLE, ID 83616-6834
(208) 412-7740
Mailing address
1025 S BRIDGEWAY PL STE 280, EAGLE, ID 83616-6834
(208) 412-7740
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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