| Doctor Name: | KIMBERLY OPAL LEDWA |
| NPI Number: | 1023315108 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC, ACADC |
| License Number: | LCPC-5248 |
| Business Practice Address: | 17678 Dark Zebra Way Nampa, ID - 836879078 |
| Business Phone Number: | 2088803785 |
| Business Fax Number: | |
| Mailing Address: | 1420 Sandal Crk, NAMPA |
| State: | ID |
| Postal Code: | 836865288 |
| Phone Number: | 2088803785 |
| Fax Number: | |
| NPI Enumeration Date: | 02/25/2011 |
| NPI Last Update Date: | 08/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LCPC-5248 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |