Individual
NIKKI RYAN SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2273 E GALA ST STE 100, MERIDIAN, ID 83642-7289
(208) 898-9999
(208) 898-8992
Mailing address
2273 E GALA ST STE 100, MERIDIAN, ID 83642-7289
(208) 898-9999
(208) 898-8992
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
146M00000X
Intermediate Emergency Medical Technician
—
—
171000000X
Military Health Care Provider
—
—
246Z00000X
Other Specialist/Technologist
Primary
TMS
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165935466
NPI
—
Enumeration date
07/11/2008
Last updated
07/21/2022
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