Individual
DULCEY LARENE BURKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
171 TEAKWOOD ST, POCATELLO, ID 83204-4970
(208) 440-3085
Mailing address
171 TEAKWOOD ST, POCATELLO, ID 83204-4970
(208) 440-3085
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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