Individual
PEIGHTON BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2667
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
ID
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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