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1912923871
KELLY E WEDEVEN
BOISE, ID
NPI
1912923871
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW24754)
Enumeration Date
2006-07-14
Last Update Date
2023-06-15
Business Address
KELLY E WEDEVEN LCSW
131 N ALLUMBAUGH ST
BOISE, ID 83704-9204
Phone number: 208-367-2175
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Mailing Address
KELLY E WEDEVEN LCSW
131 N ALLUMBAUGH ST
BOISE, ID 83704-9204
Phone number: 208-367-2175
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