Individual
BARDOMEANO MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 417-7823
Mailing address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 417-7823
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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