Nicole Manning

NPI #1366090284 in Rupert, Idaho

Provider Information

NPI Number: 1366090284
Entity Type: Individual
Name: Nicole Manning
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Sep 4, 2019
Last Updated: Sep 4, 2019

Practice Location

Address: 225 E 225 LN S
City: Rupert
State: Idaho
ZIP Code: 83350-5080
Phone: (208) 219-0451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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