Individual
KRISTY ANN PENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1301 E 17TH ST, IDAHO FALLS, ID 83404-6273
(208) 538-3122
(208) 881-5295
Mailing address
3656 E VISION DR, IDAHO FALLS, ID 83401-5045
(208) 313-7449
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-34365
ID
Other
Enumeration date
03/10/2014
Last updated
12/03/2020
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