Individual
DAKOTA LEE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(425) 407-5960
Mailing address
3216 RAY AVE, CALDWELL, ID 83605-7112
(208) 591-9556
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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