Individual
KORYL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(425) 368-3262
Mailing address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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