Individual
MICHAEL COREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 W BOISE AVE, BOISE, ID 83706-3833
(843) 609-9331
Mailing address
725 W BOISE AVE, BOISE, ID 83706-3833
(843) 609-9331
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
02/02/2022
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