Individual
AUDRA HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
598 ADDISON AVE W, TWIN FALLS, ID 83301-5039
(208) 682-1951
Mailing address
598 ADDISON AVE W, TWIN FALLS, ID 83301-5039
(208) 682-1951
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
13091
ID
Other
Enumeration date
12/09/2025
Last updated
12/10/2025
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