NPI 1194033746

Mike Anderson

Practitioner Child Intellectual and/or Developmental Disabilities Respite Care Meridian, ID

Practice location

Address: 618 NW 1st St, Meridian, ID 83642-2505
Phone: (208) 407-2077

Registered specialties

Child Intellectual and/or Developmental Disabilities Respite Care Primary

Respite Care Facility Taxonomy 385HR2060X

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Registry record

NPI: 1194033746
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Sep 2010
Record last updated: 16 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.