Individual
KRISTINA SOUTO-MAIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2995 N COLE RD STE 270&260, BOISE, ID 83704-5964
(208) 576-6464
Mailing address
2601 W BOISE AVE TRLR 8, BOISE, ID 83706-2950
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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