Kelly, Kimberly Sue

Kelly, Kimberly Sue is an sole proprietor health care provider with primary practice located at 630 S Woodruff Ave , Idaho Falls ID 83401-5299. She recently has only one registered license in Behavioral Health & Social Service Providers / Rehabilitation, which is considered as her primary health care specialty. Kelly, Kimberly Sue can be contacted via phone (208) 535-0505.

Contact Information

Primary practice address
630 S Woodruff Ave Idaho Falls ID 83401-5299
Phone: (208) 535-0505
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Rehabilitation 103TR0400X

Profile Details

NPI number 1174833966
LBN Legal business name Kelly, Kimberly Sue
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2010
Last updated Oct 14th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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