Individual
JESUS INIGUEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 S ORCHARD ST STE 102, BOISE, ID 83705-1961
(208) 919-4692
Mailing address
302 SW 4TH ST, FRUITLAND, ID 83619-2588
(208) 602-4965
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
02/22/2023
Last updated
04/23/2026
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