Individual
THEO HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7817 E MERGANSER DR, NAMPA, ID 83687-4836
(208) 353-1765
Mailing address
7817 E MERGANSER DR, NAMPA, ID 83687-4836
(208) 353-1765
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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