Individual
KATHRYN R HEYDORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7714 E WILLARD DR, NAMPA, ID 83687-8252
(208) 810-1276
(208) 895-8049
Mailing address
7714 E WILLARD DR, NAMPA, ID 83687-8252
(208) 810-1276
(208) 895-8049
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC60789946
WA
101YM0800X
Mental Health Counselor
MG60789946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871005108
NPI
—
Enumeration date
10/26/2017
Last updated
02/14/2024
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