Individual
KAYLA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6477 W FAIRVIEW AVE, BOISE, ID 83704-7717
(208) 989-0097
Mailing address
1316 E AMITY AVE, NAMPA, ID 83686-5508
(208) 989-0097
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-5274
ID
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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