Individual
JUDITH ARACELY VIELMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1224 ARTHUR ST, CALDWELL, ID 83605-3826
(208) 809-0773
Mailing address
1224 ARTHUR ST, CALDWELL, ID 83605-3826
(208) 809-0773
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BB234011I
ID
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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