Individual
HALEY KATHLEEN GOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1087 E PARK BLVD, BOISE, ID 83712
(916) 820-8369
Mailing address
505 W BROAD ST APT 502, BOISE, ID 83702-7637
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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