Individual
CONNOR VASILI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 S TOPAZ WAY UNIT 100, MERIDIAN, ID 83642-4477
(208) 417-7971
Mailing address
312 E GRUBER AVE, MERIDIAN, ID 83642-1723
(208) 315-0096
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/01/2025
Last updated
01/01/2025
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