Individual
MIRANDA UTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1087 E PARK BLVD, BOISE, ID 83712-7722
(208) 972-5254
Mailing address
15030 CUMULUS PL, CALDWELL, ID 83607-1008
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
ID
Other
Enumeration date
06/20/2026
Last updated
06/20/2026
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