Individual
MISS TYLEE NAILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1087 E. PARK BLVD., BOISE, ID 83712
(208) 369-9168
Mailing address
3303 E ANEMONE CT, BOISE, ID 83716-6848
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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