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General NPI Number Information
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NPI Number | 1518689124
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Entity Type | Organization
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Legal Business Name | SOUL CARE COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 101 11TH AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3918
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Country | US
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Telephone | 208-960-5711
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 HUNTINGTON CT
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City | NAMPA
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State | ID
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Zip | 83686-5589
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Country | US
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Telephone | 208-960-5711
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLY NELSON LOWE
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Credential | PH.D
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Telephone | 208-550-0450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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