Individual
MRS. COLLEEN IRENE SISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
8680 N WAYNE DR STE C, HAYDEN, ID 83835-5037
(208) 635-5907
(208) 635-5908
Mailing address
8680 N WAYNE DR STE C, HAYDEN, ID 83835-5037
(208) 635-5907
(208) 635-5908
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-57392
ID
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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