Healthcare Provider Details

I. General information

NPI: 1982070660
Provider Name (Legal Business Name): COLLEEN MEYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2015
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1373 S BAKER LN
POST FALLS ID
83854-4609
US

IV. Provider business mailing address

1373 S BAKER LN
POST FALLS ID
83854-4609
US

V. Phone/Fax

Practice location:
  • Phone: 206-516-1514
  • Fax:
Mailing address:
  • Phone: 208-514-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: