Individual
KATELYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 E PARK BLVD, BOISE, ID 83712-7722
(208) 369-9168
Mailing address
2975 N RECORDS AVE APT O102, MERIDIAN, ID 83646-6933
(907) 717-8084
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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