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1356995740
KACEE RUSSELL
CALDWELL, ID
NPI
1356995740
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Former Name
KACEE DONALDSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LCPC7175)
Enumeration Date
2019-07-24
Last Update Date
2019-07-24
Business Address
KACEE RUSSELL LCPC
28371 EL PASO RD
CALDWELL, ID 83607-7521
Phone number: 208-454-8847
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Mailing Address
KACEE RUSSELL LCPC
5040 FREEMONT RD
NEW PLYMOUTH, ID 83655-5425
Phone number:
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