Individual
MERRILL VELEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
703 S AMERICANA BLVD STE 150, BOISE, ID 83702-4976
(208) 706-6375
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-14074
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2012
Last updated
08/15/2022
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