Individual
MRS. LAURA HALSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 E ANEMONE CT, BOISE, ID 83716-6847
(208) 713-2252
Mailing address
3200 E ANEMONE CT, BOISE, ID 83716-6847
(208) 713-2252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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