Individual
BRYAN ROERT LAHTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.SC.
Contact information
Practice address
212 16TH AVE S, NAMPA, ID 83651-4348
(986) 895-3881
Mailing address
212 16TH AVE S, NAMPA, ID 83651-4348
(986) 895-3881
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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