Individual
ALLYSON SKIDMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 427-8816
Mailing address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 427-8816
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
—
Enumeration date
05/12/2021
Last updated
05/12/2021
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