Individual
MS. DESTINY MICHELLE BOWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
3682 N LA FONTANA WAY, BOISE, ID 83702-1527
(208) 440-9546
Mailing address
3682 N LA FONTANA WAY, BOISE, ID 83702-1527
(208) 440-9546
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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