Individual
KATHLEEN NANSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, CFSP
Contact information
Practice address
740 MCKINLEY AVE, KELLOGG, ID 83837
(208) 783-1454
Mailing address
740 MCKINLEY AVE, KELLOGG, ID 83837-2693
(208) 783-1454
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/16/2018
Last updated
07/17/2018
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