Fulfillment LLC

NPI #1346954658 in Caldwell, Idaho

Provider Information

NPI Number: 1346954658
Entity Type: Organization
Organization Name: Fulfillment LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jan 11, 2023
Last Updated: Jan 11, 2023

Practice Location

Address: 14331 CREGO ST
City: Caldwell
State: Idaho
ZIP Code: 83607-4815
Phone: (208) 290-0075

Authorized Official

Name: KENDRA JEAN NIELSON, LPC
Title: COUNSELOR
Phone: (208) 757-0067

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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