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General NPI Number Information
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NPI Number | 1922335678
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Entity Type | Individual
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Provider Name | KEN ROY MARLOWE LCPC
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Gender | Male
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1675 CURLEW DR
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City | AMMON
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State | ID
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Zip | 83406-4718
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Country | US
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Telephone | 208-523-5319
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Fax | 208-523-5627
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Provider Business Mailing Address
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Address Line | PO BOX 2106
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City | IDAHO FALLS
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State | ID
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Zip | 83403-2106
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Country | US
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Telephone | 208-523-5319
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Fax | 208-523-5627
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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 | LCPC2685
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License Number State | ID
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