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Individual

LAURYN TEMPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7960 W NORTHVIEW ST, BOISE, ID 83704-7242
(208) 375-6651
Mailing address
3617 E RENWICK ST, MERIDIAN, ID 83642-5384
(503) 522-3934

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
ID
Enumeration date
10/01/2020
Last updated
10/01/2020
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