Individual
AMANDA IRENE DYMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 N BIG TREE LN, KUNA, ID 83634-1110
(208) 546-1576
Mailing address
1300 N BIG TREE LN, KUNA, ID 83634-1110
(208) 546-1576
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
05/28/2025
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