Individual
ELISABETH GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8310 W USTICK RD STE 100, BOISE, ID 83704-6038
(208) 912-6986
Mailing address
8310 W USTICK RD STE 100, BOISE, ID 83704-6038
(208) 912-6986
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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