Individual
MRS. CYNDY ELDREDGE RADOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMA
Contact information
Practice address
917 N MAIN ST, MERIDIAN, ID 83642-2301
(208) 409-1785
Mailing address
8008 W WESLEY DR, BOISE, ID 83704-7160
(208) 409-1785
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0002769
—
ID
Enumeration date
07/11/2019
Last updated
07/11/2019
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