Individual
KIMBERLY NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9490 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 486-0556
Mailing address
9368 W MARIGOLD ST, BOISE, ID 83714-1143
(208) 515-6048
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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