Individual
CIERRA NEVEAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Mailing address
449 S FITNESS PL, EAGLE, ID 83616-6828
(208) 957-6301
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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