Individual
ELIZABETH G BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 UPPER RD, WEISER, ID 83672-2609
(208) 907-2650
Mailing address
750 UPPER RD, WEISER, ID 83672-2609
(208) 907-2650
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
09/09/2021
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