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General NPI Number Information
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NPI Number | 1245096445
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Entity Type | Organization
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Legal Business Name | TREASURE VALLEY INTERVENTION
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 4003 E DRIFTWOOD DR
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City | MERIDIAN
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State | ID
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Zip | 83642-6026
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Country | US
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Telephone | 801-458-8232
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 E DRIFTWOOD DR
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City | MERIDIAN
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State | ID
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Zip | 83642-6026
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Country | US
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Telephone | 801-458-8232
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Fax |
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Authorized Official
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Title or Position | CO-EXECUTIVE DIRECTOR
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Name | PAUL STRINGER
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Credential | MS
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Telephone | 801-458-8232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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