Individual
MARYAM SADEGHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 970-1123
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 970-1123
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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