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Individual

SUSANNAH PAIGE HEIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3622 W ROSE HILL ST APT 203, BOISE, ID 83705-5180
(208) 908-2450
Mailing address
5280 N SORRENTO DR, BOISE, ID 83704-2353
(208) 908-2450

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/21/2021
Last updated
08/03/2021
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