Individual
STEPHANIE NEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 W STATE ST STE 100, BOISE, ID 83702-4003
(208) 336-0017
Mailing address
509 W CHRISFIELD DR, MERIDIAN, ID 83646-3256
(360) 722-9349
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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