Individual
DEBORAH G POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCTMB
Contact information
Practice address
9448D W FAIRVIEW AVE # D, BOISE, ID 83704-8101
(208) 629-2006
Mailing address
9448D W FAIRVIEW AVE # D, BOISE, ID 83704-8101
(208) 629-2006
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511654-06
NATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE & BODYWORK
ID
01
—
MX 070017
BOISE CITY MASSAGE EXEMPT LICENSE
ID
Enumeration date
12/30/2008
Last updated
12/30/2008
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