| Idaho Behavior Change | |
|
2525 W Davis St Boise ID 83702-2222 | |
| (208) 995-1170 | |
| Not Available |
| Full Name | Idaho Behavior Change |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2525 W Davis St, Boise, Idaho |
| Authorized Official Name and Position | Margaret Imlay (OWNER) |
| Authorized Official Contact | 2089951170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Behavior Change 2525 W Davis St Boise ID 83702-2222 Ph: (208) 995-1170 | Idaho Behavior Change 2525 W Davis St Boise ID 83702-2222 Ph: (208) 995-1170 |
| NPI Number | 1154892065 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154892065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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