Healthcare Provider Details

I. General information

NPI: 1952235822
Provider Name (Legal Business Name): MICHAEL RICHARD SOUCIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 N COLE RD STE 150
BOISE ID
83704-5965
US

IV. Provider business mailing address

1907 1ST ST N
NAMPA ID
83687-4414
US

V. Phone/Fax

Practice location:
  • Phone: 208-703-7357
  • Fax: 208-712-6778
Mailing address:
  • Phone: 208-718-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: