Individual
KELLY ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MED
Contact information
Practice address
784 S CLEARWATER LOOP, POST FALLS, ID 83854-9599
(208) 557-1338
Mailing address
1275 APPLE ORCHARD DR, POCATELLO, ID 83204-7323
(208) 557-1338
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-8292
ID
101Y00000X
Counselor
LPC-C5413
OR
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/23/2017
Last updated
12/29/2023
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