Individual
KATHLEEN GRACE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6850 ALICE ST, BONNERS FERRY, ID 83805-8733
(406) 781-3582
Mailing address
6850 ALICE ST, BONNERS FERRY, ID 83805-8733
(406) 781-3582
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8003
ID
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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