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Individual

BERNADETTE ROSE AYALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 563-4450
Mailing address
511 W LAWNDALE DR, MERIDIAN, ID 83646-1649
(209) 355-5554

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ID

Other

Enumeration date
04/26/2022
Last updated
04/26/2022
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