Individual
SKYLER WILLOW GOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 S TOPAZ WAY UNIT 100, MERIDIAN, ID 83642-4477
(208) 972-5254
Mailing address
1206 N LILLY AVE APT 104, BOISE, ID 83713-5402
(986) 224-0647
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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