Individual
ALICIA ROSITA SHADLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(425) 407-5966
Mailing address
2006 E LINDEN ST, CALDWELL, ID 83605-5544
(425) 407-5966
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
ID
Other
Enumeration date
02/02/2026
Last updated
02/02/2026
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