Individual
STEPHANIE BAUMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11964 W ROCKHAMPTON ST, BOISE, ID 83709-5281
(208) 761-5620
Mailing address
11964 W ROCKHAMPTON ST, BOISE, ID 83709-5281
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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