Individual
VICKY MULENDELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9428 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 807-4970
Mailing address
4175 S LEANING TOWER AVE, MERIDIAN, ID 83642-5242
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/11/2025
Last updated
03/02/2026
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