Individual
FAITH SHELICE SNIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2957 E ANEMONE CT, BOISE, ID 83716-6905
(208) 401-4882
Mailing address
2957 E ANEMONE CT, BOISE, ID 83716-6905
(208) 401-4882
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
A003909
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0003909
—
ID
Enumeration date
07/25/2019
Last updated
07/25/2019
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