Individual
SHELLEY J. HUTCHINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.M.
Contact information
Practice address
701 21ST ST, LEWISTON, ID 83501-3322
(208) 553-5367
Mailing address
701 21ST ST, LEWISTON, ID 83501-3322
(208) 553-5367
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTPID015405
—
ID
Enumeration date
04/21/2020
Last updated
04/29/2020
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