Individual
MS. MARIZZA SHOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1358 ALBION AVE, BURLEY, ID 83318-1818
(208) 878-4155
(208) 878-1042
Mailing address
1358 ALBION AVE, BURLEY, ID 83318-1818
(208) 878-4155
(208) 878-1042
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
8075217
ID
Other
Enumeration date
03/01/2008
Last updated
03/01/2008
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