Individual
AMY LYTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 S ARCADIA ST, BOISE, ID 83705-6051
(208) 761-8343
Mailing address
1300 S ARCADIA ST, BOISE, ID 83705-6051
(208) 761-8343
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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