Individual
NICHOLE STREIBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4991 W HWY 54, SPIRIT LAKE, ID 83869
(208) 277-8158
Mailing address
PO BOX 1477, SPIRIT LAKE, ID 83869-1409
(208) 277-8158
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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