Individual
AUSTIN MARK LAING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
354 ORCHALARA AVE APT 3, TWIN FALLS, ID 83301-4673
(208) 490-0615
Mailing address
354 ORCHALARA AVE APT 3, TWIN FALLS, ID 83301-4673
(208) 490-0615
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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