Individual
AUTUMN EDJ ALLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 S 9TH AVE STE 103, CALDWELL, ID 83605-5072
(208) 454-8555
Mailing address
PO BOX 112, NEW PLYMOUTH, ID 83655-0112
(208) 697-2450
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-22-203613
ID
171M00000X
Case Manager/Care Coordinator
Primary
RBT-22-203613
ID
Other
Enumeration date
06/01/2022
Last updated
06/09/2026
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