Individual
KIMBERLY N BRISTOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP
Contact information
Practice address
5120 E BURNTE PEAK ST, NAMPA, ID 83687-7108
(208) 317-3092
Mailing address
5120 E BURNTE PEAK ST, NAMPA, ID 83687-7108
(208) 317-3092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3919
NE
101YM0800X
Mental Health Counselor
LCPC2912
ID
101YP2500X
Professional Counselor
LCPC9971574
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807126900
—
ID
Enumeration date
01/04/2007
Last updated
06/09/2026
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