Individual
KATIE E DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1906 FAIRVIEW AVE, CALDWELL, ID 83605-5407
(208) 402-0658
Mailing address
1906 FAIRVIEW, 220 A, CALDWELL, ID 83605
(208) 402-0658
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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