Individual
PRISCILLA CONCEPZION VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 S LINCOLN AVE, JEROME, ID 83338-2631
(208) 944-4679
(208) 944-4679
Mailing address
130 S LINCOLN AVE, JEROME, ID 83338-2631
(208) 944-4679
(208) 944-4679
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/06/2025
Last updated
05/06/2025
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