Individual
MARIA RODRIGUEZ-MONCADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 SHOUP AVE, IDAHO FALLS, ID 83402-3657
(208) 528-4061
Mailing address
150 SHOUP AVE, IDAHO FALLS, ID 83402-3657
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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