Individual
CARLA DIANE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13951 W BATTENBERG CT, BOISE, ID 83713-1275
(208) 908-9257
Mailing address
13951 W BATTENBERG CT, BOISE, ID 83713-1275
(208) 908-9257
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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