Individual
ROBERTA MENDIOLA MARATITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1087 E PARK BLVD, BOISE, ID 83712
(208) 369-9168
Mailing address
1087 E PARK BLVD, BOISE, ID 83712
(208) 369-9168
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-85861
ID
106S00000X
Behavior Technician
—
ID
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
1-25-85861
ID
Other
Enumeration date
06/28/2022
Last updated
01/22/2026
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