Most Relevant Information
Provider Data
NPI Number: | 1003527151 |
Provider Name: | CAMILLE HERMOSILLO |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 12/09/2022 |
Last Updated: | 12/09/2022 |
Provider Practice Location
4232 N WATERFORD PL
BOISE
ID
837033490
Practice Location Phone/Fax
Phone: | 2088712102 |
Fax: |
Provider Mailing Location
4232 N WATERFORD PL
BOISE
ID
837033490
Provider Mailing Phone/Fax
Phone: | 2088712102 |
Fax: |