Individual
JESSICA KELLY SHARMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAE
Contact information
Practice address
2604 S BLACKSPUR WAY, MERIDIAN, ID 83642-5120
(208) 598-6595
Mailing address
2604 S BLACKSPUR WAY, MERIDIAN, ID 83642-5120
(208) 598-6595
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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