Individual
TAYLOR DAISY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 DELAWARE AVE APT B, NAMPA, ID 83651-2801
(208) 761-3470
Mailing address
122 DELAWARE AVE APT B, NAMPA, ID 83651-2801
(208) 761-3470
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87-0986669
IRS
ID
Enumeration date
06/03/2021
Last updated
06/03/2021
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