Individual
KERRY ELDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
410 S ORCHARD ST STE 128, BOISE, ID 83705-1288
(208) 850-3542
Mailing address
12514 W MACUMBO ST, BOISE, ID 83709-5169
(208) 850-3542
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
ID
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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