Individual
KIMBERLY CORDERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
533 E RIVERSIDE DR STE 120, EAGLE, ID 83616-6585
(208) 906-3644
Mailing address
13213 N DECHAMBEAU WAY, BOISE, ID 83714-9429
(208) 906-3644
(208) 493-4331
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-28608
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902225436
—
ID
Enumeration date
08/26/2016
Last updated
12/18/2025
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