Individual
KELCEYMARIE WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
3664 S YVONNE WAY, AMMON, ID 83406-1256
(208) 243-7993
Mailing address
3664 S YVONNE WAY, AMMON, ID 83406-1256
(208) 243-7993
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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