Individual
KELLY EISENBARGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MSW
Contact information
Practice address
250 W BOBWHITE CT STE 240, BOISE, ID 83706-6656
(208) 450-5645
(208) 247-4987
Mailing address
PO BOX 533, KETCHUM, ID 83340-0481
(208) 450-5645
(208) 247-4987
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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