Individual
JESSICA FLORES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7622 E DECLARATION DR, NAMPA, ID 83687-5539
(208) 353-3177
Mailing address
7622 E DECLARATION DR, NAMPA, ID 83687-5539
(208) 353-3177
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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