Individual
LATINA ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
423 ALMOND ST, NAMPA, ID 83686-5571
(208) 703-4684
Mailing address
423 ALMOND ST, NAMPA, ID 83686-5571
(208) 703-4684
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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