Individual
RAINA SOTEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
4565 FROZEN DOG RD, EMMETT, ID 83617-9574
(909) 706-7918
Mailing address
4565 FROZEN DOG RD, EMMETT, ID 83617-9574
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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