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General NPI Number Information
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NPI Number | 1417211988
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Entity Type | Individual
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Provider Name | KIMBERLY ANN TURNBLOM MS, LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 1310 W HAYS ST
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City | BOISE
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State | ID
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Zip | 83702-5025
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Country | US
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Telephone | 208-803-5339
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Fax |
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Provider Business Mailing Address
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Address Line | 7227 W POTOMAC DR
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City | BOISE
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State | ID
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Zip | 83704-9150
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Country | US
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Telephone | 208-284-4676
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 4919
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCPC 6325
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License Number State | ID
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