Individual
KATHLEEN DANNEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2402 EDMISTON DR, IDAHO FALLS, ID 83401-4899
(208) 403-3390
Mailing address
2402 EDMISTON DR, IDAHO FALLS, ID 83401-4899
(208) 403-3390
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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