Healthcare Provider Details

I. General information

NPI: 1487408589
Provider Name (Legal Business Name): AMY HUFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N SUGAR ST
NAMPA ID
83687-6953
US

IV. Provider business mailing address

222 N SUGAR ST
NAMPA ID
83687-6953
US

V. Phone/Fax

Practice location:
  • Phone: 208-463-9313
  • Fax:
Mailing address:
  • Phone: 208-463-9313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: