Individual
ELISSA JEAN-MARIE YOUNGBLUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1915 N FARWELL LN APT 101, BOISE, ID 83713-1180
(208) 866-8757
Mailing address
1915 N FARWELL LN APT 101, BOISE, ID 83713-1180
(208) 866-8757
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4223
ID
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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