Individual
AVERY HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
370 W SHELLEY ST, IDAHO FALLS, ID 83402-2008
(208) 360-2235
Mailing address
370 W SHELLEY ST, IDAHO FALLS, ID 83402-2008
(208) 360-2235
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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