Individual
MISS LINDSAY RAE KENLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, LPC
Contact information
Practice address
533 E RIVERSIDE DR STE 120, EAGLE, ID 83616-6585
(208) 298-9886
Mailing address
2491 N DEVLIN AVE, MERIDIAN, ID 83646-5091
(208) 298-9886
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-7112
ID
101YM0800X
Mental Health Counselor
LPC-6220
ID
Other
Enumeration date
08/04/2016
Last updated
08/03/2023
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