Most Relevant Information
Provider Data
| NPI Number: | 1003647702 |
| Provider Name: | AUDRA STEVENS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/13/2024 |
| Last Updated: | 08/13/2024 |
Provider Practice Location
1087 EAST PARK BOULEVARD
SUITE 100
BOISE
ID
83712
Practice Location Phone/Fax
| Phone: | 2083699168 |
| Fax: |
Provider Mailing Location
231 N WHITEWATER PARK BLVD APT K301
BOISE
ID
837025639
Provider Mailing Phone/Fax
| Phone: | 2085060498 |
| Fax: |