Individual
MRS. JUDY ANN STALLCOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.A
Contact information
Practice address
836 W LOCUST LN, NAMPA, ID 83686-8231
(208) 466-8315
(208) 468-0566
Mailing address
836 W LOCUST LN, NAMPA, ID 83686-8231
(208) 466-8315
(208) 468-0566
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
564593
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8063404-JUDYSTALLCOP
—
ID
Enumeration date
05/11/2008
Last updated
05/11/2008
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