Individual
CARLY GAMANGASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16150 N HIGH DESERT ST STE 214, NAMPA, ID 83687-5566
(208) 860-7131
Mailing address
7295 BAY MEADOWS DR, NAMPA, ID 83687-8365
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
ID
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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