Individual
JESSE KOOPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4324 S FALCONREST WAY, BOISE, ID 83716-6673
(208) 539-7778
Mailing address
4324 S FALCONREST WAY, BOISE, ID 83716-6673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/09/2021
Last updated
05/09/2021
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