Most Relevant Information
Provider Data
| NPI Number: | 1003422122 |
| Provider Name: | ELIZABETH WARD |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/23/2020 |
| Last Updated: | 09/23/2020 |
Provider Practice Location
309 S 5TH W TRLR 12
REXBURG
ID
834402124
Practice Location Phone/Fax
| Phone: | 6028823981 |
| Fax: |
Provider Mailing Location
309 S 5TH W TRLR 12
REXBURG
ID
834402124
Provider Mailing Phone/Fax
| Phone: | 6028823981 |
| Fax: |