Individual
KATHLEEN DIEPENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
314 S RIVER ST, SUITE 202, HAILEY, ID 83333-8851
(208) 788-5625
(208) 788-5692
Mailing address
PO BOX 4683, HAILEY, ID 83333-4683
(208) 720-0941
(208) 788-5692
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC -4732
ID
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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