Individual
PATIENT NGOY BANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 N INTERLACHEN WAY, MERIDIAN, ID 83646-1011
(208) 964-0441
Mailing address
2020 N INTERLACHEN WAY, MERIDIAN, ID 83646-1011
(208) 964-0441
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
12/13/2025
Last updated
12/13/2025
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