Individual
SHANNON DYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
223 N 6TH ST STE 415, BOISE, ID 83702-5995
(208) 922-7030
Mailing address
223 N 6TH ST STE 415, BOISE, ID 83702-5995
(208) 922-7030
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-3124
ID
372500000X
Chore Provider
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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