Individual
HOLLY R EDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
11427 W VERDE LN, BOISE, ID 83709-3880
(208) 860-4810
(208) 723-2718
Mailing address
11427 W VERDE LN, BOISE, ID 83709-3880
(208) 860-4810
(208) 723-2718
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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