Individual
MRS. AMY M BERTRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 FAIRMONT ST, SALMON, ID 83467-3931
(208) 940-2031
Mailing address
208 FAIRMONT ST, SALMON, ID 83467-3931
(208) 940-2031
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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