Individual
CARMEN MARIA BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3235 E OVERLAND RD, MERIDIAN, ID 83642-6711
(888) 392-8642
Mailing address
1803 CAMBRIDGE ST, CALDWELL, ID 83607-8141
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
AD004942T
ID
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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