Individual
MATTHEW JORDAN KEZELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1363 FILLMORE ST STE B, TWIN FALLS, ID 83301-3392
(208) 734-3670
Mailing address
1363 FILLMORE ST STE B, TWIN FALLS, ID 83301-3392
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6881
ID
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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