Individual
DESIREE IRMA MASCORRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 741-6124
Mailing address
312 DENKER DR, CALDWELL, ID 83605-3007
(208) 550-0869
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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