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General NPI Number Information
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NPI Number | 1457789513
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Entity Type | Individual
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Provider Name | KATHRYN METZGER LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/28/2013
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Last Update Date | 10/28/2013
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Provider Practice Location Address
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Address Line | 2971 E COPPER POINT DR SUITE 100
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City | MERIDIAN
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State | ID
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Zip | 83642-5101
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Country | US
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Telephone | 208-376-5683
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Fax |
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Provider Business Mailing Address
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Address Line | 4618 N COLLISTER DR
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City | BOISE
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State | ID
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Zip | 83703-3719
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Country | US
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Telephone | 208-850-7849
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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 | LMSW-32242
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License Number State | ID
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