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Individual

JANESSA LYNETTE LAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1404 W IDAHO ST, BOISE, ID 83702-5002
(208) 968-7470
Mailing address
1404 W IDAHO ST, BOISE, ID 83702-5002

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67389
ID
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
CA
05
106S0000X
CA
Enumeration date
03/14/2018
Last updated
01/29/2026
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