Individual
ZACHARY KINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RECOVERY COACH
Contact information
Practice address
5230 W MOONLIGHT MINE RD, POCATELLO, ID 83201-9013
(208) 478-0219
(208) 944-9655
Mailing address
32 RAVINE DR, POCATELLO, ID 83204-4031
(608) 633-2712
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
13056
ID
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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