MS. Desiree Ann Self, MS

NPI #1528630357 in Eagle, Idaho

Provider Information

NPI Number
1528630357
Entity Type
Individual
Name
MS. Desiree Ann Self, MS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Behavior Technician
Credential
MS
Enumeration Date
Jul 12, 2021
Last Updated
Jul 12, 2021

Practice Location

Address
244 S SILVERWOOD WAY
City
Eagle
State
Idaho
ZIP Code
83616-6165
Phone
(440) 228-7161

Specialties & Taxonomy Codes

Specialty
Behavior Technician

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