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Individual

HEATHER RUBY CARPENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1276 W RIVER ST STE 100, BOISE, ID 83702-7083
(208) 338-4699
Mailing address
1008 EVERETT ST APT 1, CALDWELL, ID 83605-4176
(208) 965-5284

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
12/18/2023
Last updated
12/18/2023
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