Individual
MS. KAYLA MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
535 N LOCUST GROVE RD STE 170, MERIDIAN, ID 83642-9379
(208) 917-2660
(208) 917-2630
Mailing address
535 N LOCUST GROVE RD STE 170, MERIDIAN, ID 83642-9379
(208) 917-2660
(208) 917-2630
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3072
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAS-3072
NA
IN
Enumeration date
09/12/2019
Last updated
09/12/2019
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