Individual
MS. KATHYRN ANN SUMNER KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
980 W IRONWOOD DR, SUITE 101, COEUR D ALENE, ID 83814-2668
(208) 765-1455
Mailing address
PO BOX 996, HAYDEN, ID 83835-0996
(208) 664-4026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC361
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC361
IDAHO LICENSE NUMBER
ID
Enumeration date
11/06/2008
Last updated
11/06/2008
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