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Individual

KATHERINE RENEE WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASTERS

Contact information

Practice address
816 9TH AVE S, NAMPA, ID 83651-4542
(208) 830-3897
Mailing address
816 9TH AVE S, NAMPA, ID 83651-4542
(208) 830-3897

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/27/2022
Last updated
05/27/2022
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